Sulfonal

Sulfonal, diethylsulfone-dimethylmethane CH₃ /SO₂-C₂H₅)CH₃, CH₃ / \SO₂-C₂H₅, a colorless crystalline substance, almost odorless and tasteless, soluble in 500 parts of cold water and 15 parts of boiling water. Introduced into therapy in 1888. For a long time it was the most commonly used hypnotic due to having several advantages compared to older agents. Sleep almost always occurs without preceding excitement and is of sufficient depth. S. does not irritate the mucous membranes of the digestive organs, like chloral and paraldehyde, and does not cause constipation, like morphine and opium. Finally, when using S., phenomena of habituation that require increasing the dosage are rarely observed. S. belongs to the sulfone group. Research by Baumann and Kast showed that only those representatives of this group that decompose in the body have a hypnotic effect. It naturally follows that the hypnotic effect should be attributed not to the sulfones themselves, but to the products of their cleavage formed in the body. The second condition for the effectiveness of sulfones is the presence of ethyl groups in them, and the hypnotic action increases with the number of these groups. On this basis, after S., trional (colorless crystals, odorless, slightly bitter taste, soluble in 320 parts of cold and 10 parts of hot water), diethylsulfone-diethylmethane, was introduced into therapy. The latter of these drugs has not found application due to its unpleasant taste and side effects on the gastrointestinal tract. Trional, however, in humans also has a more intense hypnotic effect, although doses less than 1.0 do not give a sufficient effect. S. and trional are excreted from the body through the kidneys and intestines, mainly in the form of sulfocarboxylic acids. Decomposition and excretion occur slowly. A dose of 1.0 is not excreted within a day.

The disadvantages of S. follow from what has been said. Due to low solubility, and mainly dependence of action on decomposition in the body, sleep occurs 2-3 hours after administration. Due to the slowness of decomposition and excretion, the effect often extends to the next day. Very often the next morning, weakness, headaches, and dizziness are noted. The slowness of excretion creates a threat of accumulation, which sometimes occurs already on the 5-6th day. Cases of poisoning have been described even after 3 days of administration. Individual fluctuations in this regard are very great. To the manifestations of accumulation should be attributed the most unpleasant side effect of S. - methemoglobinemia and porphyrinuria, which apparently depends on poisoning by sulfocarboxylic acids. Symptoms of chronic poisoning: drowsiness, headache, dizziness, paresthesia, ataxia, state of excitement, nausea, stomach pains, constipation, diarrhea. The urine sometimes gives a dark brown-red color (uroporphyrin), often contains protein, cylinders. Oliguria is observed up to anuria. With the progression of symptoms, the case sometimes ends in death. In the picture of chronic poisoning, apparently acidosis, caused by sulfocarboxylic acids, also plays a role, for which reason the abundant administration of alkalis is recommended. The disadvantages of S. in trional are expressed less strongly. Sleep occurs faster, the post-hypnotic effect is less pronounced, the danger of accumulation is weaker. Porphyrinuria occurs less frequently and proceeds more mildly. However, cases of porphyrinuria after 3x1.0 of trional have been described. Doses 0.5-1.0-2.0 pro dosi. Both sulfonal and trional are recommended to be administered for 2-3 days, after which an interval of the same length should follow. Special caution is indicated for the elderly and exhausted patients.

Votchal. Discovery in forensic cases. The objects of research are the contents of the stomach and intestines, urine, and parts of internal organs. S. is extracted with acidified alcohol. When concentrating the alcohol extract (see Poisons, isolation), S. is partially precipitated upon cooling, therefore the extract is treated with water after removing the alcohol while boiling, and only the hot solution is filtered. Upon cooling, the aqueous liquid (together with the precipitate if present) is extracted with chloroform or ether. After evaporation of the solvent, the precipitate is tried to be recrystallized from hot water or alcohol. The residue after evaporation of chloroform or ether, or the crystals obtained during purification, is subjected to the following reactions: 1) When heated with charcoal powder, an unpleasant characteristic smell of mercaptan is perceived. When heated with iron powder, the smell of mercaptan is perceived, and when acidified with hydrochloric acid, hydrogen sulfide is released. 2) When part of the residue is fused with metallic sodium, the melt is dissolved in water: when lead acetate is added to the solution, a black precipitate of lead sulfide appears. 3) If purification of S. is possible, the determination of the melting point (125.5°) is important. The melting point serves to distinguish S. from similar trional (melting point 76°) and tetronal (melting point 86-89°). Thus, melting points, when compared with the ability to be reduced to mercaptan, serve for the detection of these compounds.