A 5 year old male patient presents with a complaint of multiple decayed teeth. His previous dental treatment was deferred because of uncooperative behavior. Which of the following drugs cannot be used for the pharmacological management of the patient’s behavior?

Chloral Hydrate is an aldehyde compound that is metabolized by alcohol dehydrogenase in the liver to its active metabolite, trichloro ethanol. In vitro studies have suggested that trichloroethanol acts upon GABA receptors in a manner similar to barbiturates and benzodiazepines. It is a chemical irritant to the skin and mucous membranes and is associated with a high rate of nausea and vomiting, particularly when administered on an empty stomach. After oral administration, the drug was characterized by a slow onset time (30 to 60 minutes) and had a duration of action of 4 to 8 hours, with an elimination half-life of 8 to 11 hours. Children given chloral hydrate would often enter a period of disinhibition resulting in excitement and irritability before reaching a level of clinically useful sedation. Large doses sensitize the myocardium to the effects of epinephrine, resulting in arrhythmias. The lethal dose of chloral hydrate is stated to be 10 g in adults, yet ingestion of 4 g has been associated with a fatal outcome. Chloral hydrate is no longer available commercially in the United States, but is included here because of its history in pediatric dentistry and references in the pediatric dentistry literature.