Medinal

MEDINAL (Medinalum), the sodium salt of diethylbarbituric acid (see Veronal), CO-NNa />CO crystalline powder, bitter in taste, readily soluble in cold water (1 : 5), sparingly in alcohol. It is used as a hypnotic; in doing so, respiration and cardiac activity are not disturbed by moderate doses of Medinal, and blood pressure drops only insignificantly; sleep occurs approximately an hour after the administration of Medinal and is distinguished by normal duration. The site of action of Medinal appears to be exclusively the central nervous system. Medinal is excreted from the organism in the urine within several days, with 50-90% being eliminated in the form of unchanged diethylbarbituric acid. The prolonged presence of Medinal (resp. veronal) in the organism often causes the hypnotic action of the drug to persist in the days immediately following its administration; chronic use of this agent can lead to cumulative phenomena—veronalism (see Veronal). To avoid the phenomena of veronalism, Medinal is not prescribed to a patient for longer than a week. Habituation to it is almost never observed.

In acute Medinal poisoning, a patient exhibits confusion, nausea, muscular weakness, and disorders of movement coordination; subsequently, mental depression passes into a stuporous condition, the skin grows cold, cyanosis and a coma set in; death results from respiratory paralysis on the second, more frequently the third day after poisoning. Depression of cardiac activity and respiration is detected only in severe cases of poisoning.—Treatment of poisoned individuals: to stimulate respiration—caffeine and strychnine subcutaneously and other respiratory center stimulants: CO₂ (5-7%), lobeline, and inhalation of pure oxygen, and in case of respiratory arrest—additionally artificial respiration; the poisoned person is kept warm.—Indications for the use of Medinal are ordinary insomnia, especially in the elderly, nausea from seasickness, as well as during airplane flights, riding in an automobile, or by train. The dose of Medinal for an adult is 0.3-0.5 an hour before bedtime per os with water, per rectum in an enema or in the form of a suppository; subcutaneously or intramuscularly with the addition of 0.01 novocaine to eliminate the pain caused by the injection of the Medinal solution; internally per os, the dose of Medinal can be increased up to 0.75. A mixture of Medinal (88.2%) with diethylbarbituric acid codeine (11.8%) is known under the name Codeonal; it is manufactured in 0.17 tablets and in powders. The detection of Medinal in forensic cases is carried out by methods analogous to those used for the detection of veronal (see).