Generic Name

Ethchlorvynol

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Classification

FDA Approved Indications

• Short-term management of insomnia

Mechanism of Action

Ethchlorvynol enhances the activity of gamma-aminobutyric acid (GABA) at GABA-A receptors, producing sedative and hypnotic effects.

Dosage and Administration

Adult: Usually 200-300 mg at bedtime, may be adjusted based on response. Not to exceed 600 mg/day.

Pediatric: Not recommended for use in children due to safety concerns.

Geriatric: Use with caution; start at lower doses due to increased sensitivity and risk of adverse effects.

Renal Impairment: Adjust dose based on renal function; close monitoring advised.

Hepatic Impairment: Use with caution; dose adjustment may be necessary.

Pharmacokinetics

Absorption: Well absorbed orally.

Distribution: Widely distributed in body tissues; crosses the blood-brain barrier.

Metabolism: Minimal hepatic metabolism.

Excretion: Primarily excreted unchanged in the urine.

Half Life: Approximately 4-8 hours.

Contraindications

• Hypersensitivity to ethchlorvynol or related compounds.
• Severe hepatic or renal impairment.

Precautions

• Use with caution in elderly patients, patients with a history of substance abuse, or respiratory depression.
• Potential for dependence, abuse, and withdrawal symptoms.

Adverse Reactions - Common

• Drowsiness, dizziness (Common)
• Impaired coordination (Common)

Adverse Reactions - Serious

• Retinal toxicity, visual disturbances (Rare)
• Respiratory depression, neuroleptic malignant syndrome (Rare)

Drug-Drug Interactions

• CNS depressants (e.g., alcohol, benzodiazepines, opioids) increase sedative effects.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Patient/Family Teaching

• Avoid alcohol and other CNS depressants while taking this medication.
• Do not operate heavy machinery until effects are known.
• Report signs of allergic reactions, unusual sleepiness, or mood changes.

Special Considerations

Black Box Warnings:

• Potential for dependence, abuse, and withdrawal if used long-term or in high doses.

Genetic Factors: No specific genetic testing recommended.

Lab Test Interference: May interfere with sleep studies and liver function tests.

Overdose Management

Signs/Symptoms: Profound sedation, respiratory depression, coma, hypotension.

Treatment: Supportive care, airway management, activated charcoal if ingestion is recent, and benzodiazepines for seizures if necessary.

Storage and Handling

Storage: Store at room temperature away from moisture and light.

Stability: Stable under recommended storage conditions.