CN112009875A - Kit containing chloral hydrate and application thereof - Google Patents
Kit containing chloral hydrate and application thereof Download PDFInfo
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- B—PERFORMING OPERATIONS; TRANSPORTING
- B65—CONVEYING; PACKING; STORING; HANDLING THIN OR FILAMENTARY MATERIAL
- B65D—CONTAINERS FOR STORAGE OR TRANSPORT OF ARTICLES OR MATERIALS, e.g. BAGS, BARRELS, BOTTLES, BOXES, CANS, CARTONS, CRATES, DRUMS, JARS, TANKS, HOPPERS, FORWARDING CONTAINERS; ACCESSORIES, CLOSURES, OR FITTINGS THEREFOR; PACKAGING ELEMENTS; PACKAGES
- B65D81/00—Containers, packaging elements, or packages, for contents presenting particular transport or storage problems, or adapted to be used for non-packaging purposes after removal of contents
- B65D81/32—Containers, packaging elements, or packages, for contents presenting particular transport or storage problems, or adapted to be used for non-packaging purposes after removal of contents for packaging two or more different materials which must be maintained separate prior to use in admixture
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61J—CONTAINERS SPECIALLY ADAPTED FOR MEDICAL OR PHARMACEUTICAL PURPOSES; DEVICES OR METHODS SPECIALLY ADAPTED FOR BRINGING PHARMACEUTICAL PRODUCTS INTO PARTICULAR PHYSICAL OR ADMINISTERING FORMS; DEVICES FOR ADMINISTERING FOOD OR MEDICINES ORALLY; BABY COMFORTERS; DEVICES FOR RECEIVING SPITTLE
- A61J1/00—Containers specially adapted for medical or pharmaceutical purposes
- A61J1/05—Containers specially adapted for medical or pharmaceutical purposes for collecting, storing or administering blood, plasma or medical fluids ; Infusion or perfusion containers
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K31/00—Medicinal preparations containing organic active ingredients
- A61K31/11—Aldehydes
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
- A61K47/06—Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite
- A61K47/26—Carbohydrates, e.g. sugar alcohols, amino sugars, nucleic acids, mono-, di- or oligo-saccharides; Derivatives thereof, e.g. polysorbates, sorbitan fatty acid esters or glycyrrhizin
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A—HUMAN NECESSITIES
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- A61K9/00—Medicinal preparations characterised by special physical form
- A61K9/0087—Galenical forms not covered by A61K9/02 - A61K9/7023
- A61K9/0095—Drinks; Beverages; Syrups; Compositions for reconstitution thereof, e.g. powders or tablets to be dispersed in a glass of water; Veterinary drenches
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K9/00—Medicinal preparations characterised by special physical form
- A61K9/08—Solutions
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P25/00—Drugs for disorders of the nervous system
- A61P25/20—Hypnotics; Sedatives
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Abstract
The present invention relates to a kit comprising a first container containing a chloral hydrate concentrate and a second container containing a diluent and to the use of said chloral hydrate concentrate and diluent for the preparation of a medicament for use as a sedative hypnotic agent.
Description
Technical Field
The present invention relates to a kit comprising a first container containing a chloral hydrate concentrate and a second container containing a diluent and to the use of said chloral hydrate concentrate and diluent for the preparation of a medicament for use as a sedative hypnotic agent.
Background
The diagnosis and treatment of childhood diseases usually require a variety of medical examinations such as nuclear magnetic resonance, CT, electrocardiogram, electroencephalogram, ophthalmic examination, dental examination, and the like. The children as a special group have immature psychological development, are far inferior to adults in the control capability of self emotion and behavior in the diagnosis and treatment process, are easy to generate fear, uneasiness, dysphoria, anxiety and even agitation, and further have the phenomena of escaping or refusing treatment and the like, so that the diagnosis and treatment process is difficult to carry out. Therefore, before diagnosis and treatment, children are often required to take sedative hypnotic agents to keep the sedative hypnotic agents calm, relieve anxiety and fear, and guarantee smooth diagnosis and treatment process.
At present, the hospital preparation of chloral hydrate oral solution is generally adopted clinically as the sedative hypnotic for pediatric examination. Chloral hydrate mainly inhibits an ascending activation system of a brain stem network structure to cause near physiological sleep, and has the advantages of quick response, long action time, no shortening of quick eye movement phase sleep, mild action, no accumulation in vivo and less adverse reaction. The chloral hydrate oral solution is a sedative hypnotic drug which has the longest application time, the most extensive application, the most mature application and the largest dosage in the pediatric examination in China hospitals, becomes a preferred sedative hypnotic drug in the pediatric examination in China, and does not have a proper substitute drug at present.
The product self-made by hospitals has poor stability, 5 percent concentration product needs refrigeration, the validity period is only 30 days, and 10 percent concentration product is stored at room temperature (25 ℃) and the validity period is about 35 days. The literature reports that the inclusion compound is prepared by adding beta-cyclodextrin into chloral hydrate oral solution in an attempt to improve the stability. However, the effective period of the product is only prolonged to 46.63 days (Song Yongxi, Lifuyingli, Liqianmei, preparation of a chloral hydrate mucilage and stability prediction [ J ] Tianjin pharmacy, 2002, 14 (2): 48-48), and the product is not substantially improved. Therefore, the problem of effectively improving the stability of the chloral hydrate oral solution is solved, and no effective method is reported. In addition, the hospital preparation is only used in the preparation hospital, and cannot be sold to the outside, and for the vast middle-sized and small-sized hospitals and primary hospitals which do not have the preparation condition, the chloral hydrate preparation is difficult to obtain, and the clinician often has to select the medicines such as the phenobarbital sodium, the propofol, the ketamine injection and the like with large toxic and side effects. Compared with oral medicines, the injection is inconvenient to use and has poor compliance of children.
Disclosure of Invention
In one aspect, the invention provides a kit comprising a first container containing a chloral hydrate concentrate and a second container containing a diluent.
In the kit of the present invention, the chloral hydrate concentrate having a higher chloral hydrate concentration and a lower pH value is stored separately from the diluent until use, thereby significantly improving the stability of chloral hydrate, reducing the generation of impurities, and significantly increasing the effective period of the preparation. In addition, when in use, the chloral hydrate concentrated solution and the diluent in the medicine box can be orally taken by patients (particularly children patients) after being mixed, the operation is simple and convenient, and meanwhile, the diluent improves the taste, reduces the stimulation and has good compliance of the patients.
In another aspect, the present invention provides the use of the above chloral hydrate concentrate and diluent for the preparation of a medicament for use as a sedative hypnotic agent.
In another aspect, the present invention provides the above-described kit for use as a sedative hypnotic agent.
In another aspect, the present invention provides a method for preparing chloral hydrate oral preparation, which comprises mixing the above chloral hydrate concentrated solution and diluted solution before use.
In another aspect, the present invention provides a method of inducing sedation and sleep in a patient, particularly a pediatric patient, comprising administering to the patient an oral dosage of chloral hydrate of the present invention.
Detailed Description
In some embodiments, the present invention provides a kit comprising a first container comprising a chloral hydrate concentrate and a second container comprising a diluent.
As used herein, the term "kit" refers to a package comprising at least two separate containers, wherein a first container contains a chloral hydrate concentrate and a second container contains a diluent. The "kit" may further comprise instructions for administering all or part of the contents of the first and second containers to a patient, and a removal device for removing the contents of the first and/or second containers.
In a preferred embodiment, the mass volume concentration of the chloral hydrate in the mixed solution prepared from the chloral hydrate concentrate and the diluent is less than 50 w/v%, such as less than 30 w/v%, less than 20 w/v%, less than 15 w/v%, less than 10 w/v% or less than 5 w/v%.
As used herein, "w/v%" means a mass-to-volume concentration, for example, "the mass-to-volume concentration of chloral hydrate is 1 w/v%" means that 1g of chloral hydrate is contained in 100mL of the mixed solution.
In a preferred embodiment, the invention provides a kit further comprising a removing device (e.g. a syringe) for removing the contents of one container to mix it with the contents of another container. In one embodiment, the removing means is for removing the chloral hydrate concentrate in the first container to mix it with the diluent in the second container. In another embodiment, the removing means is for removing at least a portion of the chloral hydrate concentrate in the first container to mix it with at least a portion of the diluent in the second container.
In a preferred embodiment, the present invention provides a kit, wherein the chloral hydrate concentrate comprises chloral hydrate, a pharmaceutically acceptable acid and water (preferably purified water), wherein the mass concentration of the chloral hydrate is 40% -80% (e.g., 44% -80%, 44% -70%, 44% -60% or 44% -50%), and the pH of the chloral hydrate concentrate is preferably 1.0-2.9.
As used herein, mass concentration refers to the weight ratio (w/w%) of the components.
In a preferred embodiment, the invention provides a kit, wherein the pharmaceutically acceptable acid is an inorganic or organic acid, wherein
The inorganic acid is selected from the group consisting of hydrochloric acid, hydrobromic acid, hydroiodic acid, sulfuric acid, nitric acid, boric acid, phosphoric acid, and any combination thereof;
the organic acid is selected from the group consisting of formic acid, acetic anhydride, acetoacetic acid, trifluoroacetic acid, propionic acid, pyruvic acid, butyric acid, caproic acid, enanthic acid, undecanoic acid, lauric acid, stearic acid, palmitic acid, oxalic acid, malonic acid, succinic acid, glutaric acid, adipic acid, maleic acid, fumaric acid, lactic acid, malic acid, citric acid, tartaric acid, meta tartaric acid, ascorbic acid, gallic acid, benzoic acid, salicylic acid, cinnamic acid, naphthoic acid, pamoic acid, nicotinic acid, orotic acid, phytic acid, methylsulfate, dodecylsulfate, methanesulfonic acid, trifluoromethanesulfonic acid, ethanedisulfonic acid, isethionic acid, 1, 5-naphthalenedisulfonic acid, 2-naphthalenesulfonic acid, camphorsulfonic acid, sulfamic acid, glutamic acid, aspartic acid, gluconic acid, glucuronic acid and any combination thereof;
preferably, the pharmaceutically acceptable acid is hydrochloric acid, sulfuric acid, phosphoric acid, acetic acid, lactic acid, malic acid, tartaric acid, fumaric acid, citric acid monohydrate or citric acid anhydrous.
In some embodiments, the pharmaceutically acceptable acids described above may also be used as pH adjusting agents in the diluent.
In a preferred embodiment, the present invention provides a kit wherein the chloral hydrate concentrate comprises the following ingredients: chloral hydrate, citric acid monohydrate or anhydrous citric acid and purified water, wherein the mass concentration of the chloral hydrate is 44% -80%, and the pH value of the chloral hydrate concentrated solution is 1.0-2.9.
In a preferred embodiment, the present invention provides a kit wherein the chloral hydrate concentrate has a pH of 1.0 to 2.0, such as 1.2 to 1.6, 1.31 to 2.0, or 1.61 to 2.0.
In a preferred embodiment, the present invention provides a kit wherein the concentration by mass of chloral hydrate in said chloral hydrate concentrate is 75%.
In a preferred embodiment, the present invention provides a kit wherein the diluent comprises a sweetener (e.g. sucrose and/or sucralose), a pH adjusting agent (a pharmaceutically acceptable acid as described above, e.g. a mineral or organic acid, preferably citric acid anhydrous or citric acid monohydrate) and a solvent (e.g. water).
In a preferred embodiment, the invention provides a kit wherein the diluent further comprises a complexing agent (e.g. disodium edetate).
In a preferred embodiment, the invention provides a kit wherein the diluent further comprises a fragrance (e.g. raspberry flavor).
In a preferred embodiment, the invention provides a kit wherein the diluent further comprises a preservative (e.g. sodium benzoate).
In a preferred embodiment, the invention provides a kit wherein the dilution has a pH of 1.5 to 3.0, preferably 2.0 to 3.0.
In a preferred embodiment, the invention provides a kit wherein the diluent comprises 20-70 w/v% (e.g. 30-70 w/v% or 40-70 w/v%) sweetener.
In a preferred embodiment, the invention provides a kit wherein the diluent comprises 0.1-10 w/v% (e.g. 0.1-5 w/v% or 0.1-2 w/v%) of a pH adjusting agent.
In a preferred embodiment, the invention provides a kit wherein the diluent comprises 0-0.3 w/v% (e.g. 0.001-0.1 w/v% or 0.001-0.05 w/v%) of the complexing agent.
The present inventors have unexpectedly found that when the content of the complexing agent is more than 0, the solution obtained by mixing the chloral hydrate concentrate and the diluent in the kit of the present invention can be kept stable (i.e., the amount of impurities (e.g., chloroform or trichloroacetic acid) generated is small) for a long period of time (e.g., 3 months, 6 months, 12 months) when left at room temperature. Thus, the chloral hydrate concentrate and the diluent in the kit of the present invention can be mixed and the resulting solution can be administered to a patient immediately, while the resulting solution can still be administered to a patient after being left at room temperature for a certain period of time (e.g., 3 months, 6 months, 12 months).
In a preferred embodiment, the invention provides a kit wherein the diluent comprises from 0 to 2 w/v% (e.g. from 0.1 to 1 w/v% or from 0.1 to 0.5 w/v%) of a fragrance.
In a preferred embodiment, the invention provides a kit wherein the diluent comprises 0-1 w/v% (e.g. 0.001-0.5 w/v% or 0.005-0.2 w/v%) of a preservative.
In a preferred embodiment, the invention provides a kit wherein the diluent comprises 20-75 w/v% (e.g. 20-60 w/v% or 20-50 w/v%) of a solvent.
In a preferred embodiment, the present invention provides a kit wherein the diluent comprises the following components:
components | Content range |
Sucrose | 20-68w/v% |
Sucralose | 0-2w/v% |
Citric acid monohydrate/anhydrous citric acid | 0.1-10w/v% |
Raspberry essence | 0-2w/v% |
Sodium benzoate | 0-1w/v% |
Edetate disodium | 0-0.3w/v% |
Water (W) | 20-75w/v%。 |
In an embodiment of the invention, the content of sweeteners, pH regulators, complexing agents, fragrances, preservatives and solvents in the diluent is in total not higher than 100 w/v%; preferably, the content of sweetener, pH regulator, complexing agent, fragrance, preservative and solvent in the diluent amounts to 100 w/v%.
Examples
Specific embodiments of the present invention are further illustrated below with reference to specific examples, which are not provided to limit the scope of the invention.
Chloral hydrate used in the following examples was purchased from Qingdao Yulong seaweed, Inc. Other raw and auxiliary materials are purchased from Beijing Phoenix extract medical and drug Co.
In the test examples, chloral hydrate content refers to the percentage relative to the labeled amount (i.e., the theoretical amount of chloral hydrate per unit of formulation or label-labeled amount). Sodium benzoate content refers to the percentage relative to the theoretical content in the formulation.
As used herein, the amount of degradants (e.g., chloroform or trichloroacetic acid) is expressed as the amount of degradants per 1g chloral hydrate (μ g).
EXAMPLE 1 preparation of chloral hydrate concentrate
Taking anhydrous citric acid (0.1g), placing in a glass beaker, adding purified water (3.3g), stirring for dissolving, slowly and continuously adding chloral hydrate (10g) under stirring, stirring at a constant speed (300r/min) until the chloral hydrate is completely dissolved, filtering, and encapsulating to obtain chloral hydrate concentrated solution (pH 1.25).
EXAMPLE 2 preparation of Diluent
Purified water (0.91ml) was taken, placed in a beaker, and sodium benzoate (0.1g) was added, stirred and dissolved to obtain a sodium benzoate solution.
And adding purified water (45.5ml) into a glass beaker, heating and boiling, adding sucrose (60.05g), sucralose (0.1g) and edetate disodium (0.01g), stirring and dissolving, boiling for 30min, stopping heating, cooling to below 80 ℃, adding anhydrous citric acid (0.91g), a sodium benzoate solution and raspberry essence (0.4g), adding purified water to a constant volume of 91ml, stirring, filtering, and encapsulating to obtain a diluent (pH 2.48).
EXAMPLE 3 preparation of Diluent
Purified water (0.91ml) was taken, placed in a beaker, and sodium benzoate (0.1g) was added, stirred and dissolved to obtain a sodium benzoate solution.
And putting purified water (45.5ml) into a glass beaker, heating and boiling, adding sucrose (60.05g) and sucralose (0.1g), stirring for dissolving, boiling for 30min, stopping heating, cooling to below 80 ℃, adding anhydrous citric acid (0.91g), a sodium benzoate solution and raspberry essence (0.4g), adding purified water to reach a constant volume of 91ml, stirring uniformly, filtering, and encapsulating to obtain a diluent (pH 2.36).
Test example 1 stability test
The commercial products, the hospital self-made preparations and the products of the application are placed under the condition of high temperature (60 +/-2 ℃), and the amount of the generated trichloromethane in the products is detected on the 0 th day, the 10 th day and the 30 th day, and the results are shown in table 1.
TABLE 1 test results of chloroform production (. mu.g/g)
Note: "/" indicates not tested.
The commercial product has a sharp rise in chloroform content after 30 days at high temperature, particularly the Canadian product reaches 4064.02 mug/g, which is far beyond the limit specification of 120 mug/g ICH. Similarly, the hospital home-made preparation has a sharp rise in chloroform content after being left for 10 days at high temperature, wherein the maximum is 3945.72 mug/g, which is far beyond the limit of 120 mug/g.
The product of the application has small increase of the content of the trichloromethane under the high temperature condition, and the content of the trichloromethane is lower than the limit regulation of 120 mu g/g after 30 days. Therefore, the stability of the chloral hydrate in the product is obviously improved, and the product has better quality stability and safety.
In addition, by comparing product 1 and product 2 of the present application, it can be seen that the addition of disodium edetate to the dilution further reduces the amount of chloroform produced after the same time of storage. Therefore, the product of the application can be used immediately after the concentrated solution and the diluent are mixed, and the mixed solution of the concentrated solution and the diluent can be used after being placed for a period of time.
Test example 2 Long-term stability test
The concentrated solution (1g) of example 1 and the diluted solution (9.1ml) of example 2 were used to prepare a clinical solution, which was subjected to a long-term stability test at 25 ℃. + -. 2 ℃ and RH 60%. + -. 5% at months 0, 3, 6 and 12, and the results are shown in Table 2.
Table 2 long term stability test results
As can be seen from the above data, the product of the present application has better long-term stability.
Various modifications of the invention in addition to those described herein will be apparent to those skilled in the art from the foregoing description. Such modifications are also intended to fall within the scope of the appended claims. Each reference, including all patents, patent applications, journal articles, books, and any other publications, cited in this application is hereby incorporated by reference in its entirety.
Claims (14)
1. A kit comprising a first container containing a chloral hydrate concentrate and a second container containing a diluent, the mass volume concentration of chloral hydrate in a mixture prepared from the chloral hydrate concentrate and the diluent being less than 50 w/v%, such as less than 30 w/v%, less than 20 w/v%, less than 15 w/v%, less than 10 w/v% or less than 5 w/v%.
2. The kit of claim 1, further comprising a removal device, such as a syringe.
3. The kit according to claim 1 or 2, wherein the chloral hydrate concentrate comprises chloral hydrate, a pharmaceutically acceptable acid and water (preferably purified water), wherein the mass concentration of the chloral hydrate is 40% to 80% (e.g. 44% to 80%, 44% to 70%, 44% to 60% or 44% to 50%), and the pH value of the chloral hydrate concentrate is preferably 1.0 to 2.9.
4. The kit of claim 3, wherein the pharmaceutically acceptable acid is an inorganic acid or an organic acid, wherein
The inorganic acid is selected from the group consisting of hydrochloric acid, hydrobromic acid, hydroiodic acid, sulfuric acid, nitric acid, boric acid, phosphoric acid, and any combination thereof;
the organic acid is selected from the group consisting of formic acid, acetic anhydride, acetoacetic acid, trifluoroacetic acid, propionic acid, pyruvic acid, butyric acid, caproic acid, enanthic acid, undecanoic acid, lauric acid, stearic acid, palmitic acid, oxalic acid, malonic acid, succinic acid, glutaric acid, adipic acid, maleic acid, fumaric acid, lactic acid, malic acid, citric acid, tartaric acid, meta tartaric acid, ascorbic acid, gallic acid, benzoic acid, salicylic acid, cinnamic acid, naphthoic acid, pamoic acid, nicotinic acid, orotic acid, phytic acid, methylsulfate, dodecylsulfate, methanesulfonic acid, trifluoromethanesulfonic acid, ethanedisulfonic acid, isethionic acid, 1, 5-naphthalenedisulfonic acid, 2-naphthalenesulfonic acid, camphorsulfonic acid, sulfamic acid, glutamic acid, aspartic acid, gluconic acid, glucuronic acid and any combination thereof;
preferably, the pharmaceutically acceptable acid is hydrochloric acid, sulfuric acid, phosphoric acid, acetic acid, lactic acid, malic acid, tartaric acid, fumaric acid, citric acid monohydrate or citric acid anhydrous.
5. The kit of any one of claims 1-4, wherein the chloral hydrate concentrate comprises the following ingredients: chloral hydrate, citric acid monohydrate or anhydrous citric acid and purified water, wherein the mass concentration of the chloral hydrate is 44% -80%, and the pH value of the chloral hydrate concentrated solution is 1.0-2.9.
6. The kit according to any of claims 3 to 5, wherein the chloral hydrate concentrate has a pH value of 1.0 to 2.0, such as 1.2 to 1.6, 1.31 to 2.0 or 1.61 to 2.0.
7. The kit according to any one of claims 3 to 6, wherein the chloral hydrate is present at a concentration of 75% by mass.
8. The kit of any one of claims 1-7, wherein the diluent comprises a sweetener (e.g., sucrose and/or sucralose), a pH adjusting agent (e.g., an inorganic or organic acid, preferably citric acid anhydrous or citric acid monohydrate), and a solvent (e.g., water).
9. The kit of claim 8, wherein the diluent further comprises a complexing agent (e.g., disodium edetate).
10. The kit of claim 8 or 9, wherein the diluent further comprises a fragrance (e.g. raspberry essence) and/or a preservative (e.g. sodium benzoate).
11. The kit of any one of claims 8 to 10, wherein the pH of the diluent is from 1.5 to 3.0, preferably from 2.0 to 3.0.
12. The kit of claim 11, wherein the diluent comprises 20-70 w/v% of a sweetener, 0.1-10 w/v% of a pH adjusting agent, 0-0.3 w/v% of a complexing agent, 0-2 w/v% of a fragrance, 0-1 w/v% of a preservative, and 20-75 w/v% of a solvent.
14. use of a kit according to any one of claims 1 to 13 for the preparation of a medicament for use as a sedative hypnotic agent.
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CN201910466210.2A CN112009875B (en) | 2019-05-30 | 2019-05-30 | Kit containing chloral hydrate and application thereof |
PCT/CN2020/093145 WO2020239052A1 (en) | 2019-05-30 | 2020-05-29 | Chloral hydrate-containing medicinal kit and uses thereof |
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Cited By (2)
Publication number | Priority date | Publication date | Assignee | Title |
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WO2023000271A1 (en) * | 2021-07-22 | 2023-01-26 | 深圳先进技术研究院 | Application of chloral hydrate in preparation of drug for inhibiting re-taking and dependence of amphetamine stimulant |
CN116999388A (en) * | 2022-04-27 | 2023-11-07 | 北京弘生医药科技有限公司 | Oral solution of chloral hydrate |
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