Sulfonal

SULFONAL, diethylsulfone-dimethylmethane CH₃\ /SO₂-C₂H₅ )C< , is a colorless crystalline CH₃/ \SO₂-C₂H₅ substance, almost odorless and tasteless, soluble in 500 parts of cold water and 15 parts of boiling water. It was introduced into therapy in 1888. For a long time, it was the most commonly used hypnotic due to several advantages over older remedies. Sleep occurs almost always without preceding excitation and is characterized by sufficient depth. Sulfonal does not irritate the mucous membrane of the digestive organs, like chloral hydrate and paraldehyde, nor does it cause constipation, like morphine and opium. Finally, during the use of sulfonal, there are almost no phenomena of habituation that force an increase in dosage. Sulfonal belongs to the sulfone group. Research by Baumann and Kast showed that only those representatives of this group that decompose in the organism possess hypnotic action. From this, it naturally follows that the hypnotic effect should be ascribed not to the sulfones themselves, but to their cleavage products formed in the organism. The second condition for the effectiveness of sulfones is the presence of ethyl groups in them, with the hypnotic action increasing with the number of these groups. On this basis, following sulfonal, trional was introduced into therapy (colorless crystals, odorless, slightly bitter taste, soluble in 320 parts of cold and 10 parts of hot water)

CH₃\ /SO₂C₂H₅ >C< , diethylsulfone-diethylmethane. The latter of these preparations did not find application due to its unpleasant taste and side effects from the gastrointestinal tract. Trional also has a more intensive hypnotic action in humans, although doses below 1.0 do not give a sufficient effect. Sulfonal and trional are excreted from the organism through the kidneys and intestines, mainly in the form of sulfonic acids. Decomposition and elimination occur slowly. A dose of 1.0 is not eliminated within a day. The disadvantages of sulfonal follow from what has been said. Due to its low solubility, and mainly the dependence of its action on decomposition in the organism, sleep occurs 2-3 hours after administration. Due to the slowness of decomposition and excretion, the action often extends into the following day. Very often on the next morning, weakness, headaches, and dizziness are noted. The slowness of excretion creates the threat of cumulation, sometimes occurring already on the 5th-6th day. Cases of poisoning have been described even after a 3-day intake. Individual variations in this respect are very great. The most unpleasant side effect of sulfonal—methemoglobinemia and porphyrinuria, apparently depending on poisoning by sulfonic acids—should be classified among the manifestations of cumulation. Symptoms of chronic poisoning include drowsiness, headache, dizziness, paresthesias, ataxia, a state of excitation, nausea, stomach pain, constipation, and diarrhea. The urine sometimes acquires a dark brownish-red color (uroporphyrin) and often contains protein and casts. Oliguria up to anergy is observed. With the progression of symptoms, the case sometimes ends in death. Acidosis caused by sulfonic acids apparently also plays a part in the clinical picture of chronic poisoning, as a result of which abundant administration of alkalis is recommended. The disadvantages of sulfonal are less pronounced in trional. Sleep occurs faster, the posthypnotic effect is less pronounced, and the danger of cumulation is weaker. Porphyrinuria occurs less frequently and proceeds more mildly. However, cases of porphyrinuria have been described after 3x1.0 of trional. Doses are 0.5-1.0-2.0 pro dosi. Both sulfonal and trional are recommended to be given for 2-3 days, after which an equal interval should follow. Particular caution is indicated in the elderly and exhausted patients.

W. Votschal. Detection in forensic medical cases. The objects of investigation are the contents of the stomach and intestines, urine, and parts of internal organs. Sulfonal is extracted with acidified alcohol. Upon concentration of the alcoholic extract (see Poisons, Isolation), sulfonal is partly precipitated upon cooling; therefore, the treatment of the extract with water after removal of the alcohol is performed at boiling point, 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 attempted to be recrystallized from hot water or alcohol. The residue after evaporation of chloroform or ether, or the crystals obtained upon purification, are subjected to the following reactions: 1) Upon heating with charcoal powder, an unpleasant peculiar smell of mercaptan is felt. Upon heating with iron powder, the smell of mercaptan is felt, and upon acidification with hydrochloric acid, hydrogen sulfide is liberated. 2) Upon ignition of a portion of the residue with metallic sodium, the alloy is dissolved in water: upon addition of lead acetate to the solution, a black precipitate of lead sulfide appears. 3) If purification is possible, the determination of the melting point (125.5°) is of significance. The melting point serves to distinguish sulfonal from its analogs, 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 the named compounds.