Chloral hydrate 'unpredictable' for pediatric use

The University of Florida has decided to discontinue the use of chloral hydrate following the 2010 death of a 5-year-old Florida boy who was sedated with the drug prior to dental work.

In April 2010, Dylan Shane Stewart went to the office of Ronnie Grundset, DDS, a longtime Gainesville-area pediatric dentist, to have four fillings and eight crowns placed, according to the Alachua County Sheriff's Office. After being sedated with chloral hydrate, he went into cardiac arrest and died a short time later.

The amount of chloral hydrate administered orally to Stewart was "far more" than the recommended dosage and caused a toxic reaction, according to a story in the Gainsville Sun.

The sedative is still in use in some local dental offices, but a committee on pharmacy and therapeutics at Shands at the University of Florida -- a private, not-for-profit hospital that specializes in tertiary care for critically ill patients -- decided in November to remove the drug from the hospital formulary, and it can no longer can be used for inpatient treatment, the story stated.

The drug hasn't been used for several years at the university's pediatric dental clinic.

Leslie Hendeles, a professor of pharmacology and pediatrics, brought Stewart's case to the Shands committee last month, along with medical literature on the sedative and other cases of fatal chloral hydrate overdoses.

According to Hendeles, the drug is safe and effective if the exact dosage is used, but it is "not forgiving" if too much is accidentally given.

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