CHLORAL HYDATE:

Drug is used primarily in pediatric patients.

Description: 

A pure sedative hypnotic with no analgesic properties. It may produce a state of disinhibition with an agitated response to noxious stimuli.  It is used as an adjunct for painful therapeutic procedures. Most effective in children less than 4 years of age.  See table for more information.

Dosage and Route of Administration:

Oral:  25-100 mg/kg up to 1g dose (max of 2g in 2 divided doses)

Onset: 15-30 Minutes

Peak effect: 30-60 minutes

Duration: 60 minutes (residual sedation may persist for 10 or more hours in toddlers, but 20 hours or more in neonates)

Adverse reactions

  • Desaturation, respiratory depression and airway obstruction, agitation, ataxia, vomiting, cardiac arrhythmias.

  • Increased risk of direct and indirect hyperbilirubinemia and kernicterus in newborns.

  • Metabolic acidosis with repeat administration particularly in neonates. 

  • Not recommended for repeat use in neonates. 
  • Single use will produce prolonged sedation in preterm infants and full-term infants< 1 month of age.

Drug interactions

  • Cautious use with other sedatives or opioids – may increase the risk of respiratory complications. 
  • May alter the rate of metabolism of warfarin or warfarin-related anticoagulants.

Contraindications

  • Preterm and term neonates (repeat dosing).

  • Should not be used on a chronic basis

  • Patients with significant hepatic or renal disease

  • Patients with cardiac dysrhythmias

  • Patients who have previously exhibited an idiosyncrasy or hypersensitivity to the drug

  • Oral dose contraindicated in patients with gastritis

  • Patients with Porphyria 

Antagonist

  • None Avaliable

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