CHLORAL HYDRATE
Standard Prescription
chloral hydrate __mg PO{PR} x 1 dose (__mg/kg/dose)
chloral hydrate __mg PO{PR} Q H PRN for sedation (__mg/kg/dose)
chloral hydrate __mg PO{PR} Q H PRN for sedation (__mg/kg/dose)
Dosages
Sedation:
Pre-Procedural Sedation:
50-75 mg/kg/dose PO/PR 60 min. prior to procedure. Lower doses of 20-50 mg/kg/dose may be used for some procedures (eg EEG)
Recommended dose in outpatient clinics is 50 mg/kg/dose.
Maximum: 1500 mg/dose
5-15 mg/kg/dose PO/PR Q4H.
Maximum: 2000 mg/day
Pre-Procedural Sedation:
50-75 mg/kg/dose PO/PR 60 min. prior to procedure. Lower doses of 20-50 mg/kg/dose may be used for some procedures (eg EEG)
Recommended dose in outpatient clinics is 50 mg/kg/dose.
Maximum: 1500 mg/dose
Mechanism of Action
Hypnotic and sedative. Metabolized to trichloroethanol, which is responsible for its physiological and psychological effects and exerts its pharmacological properties via enhancing the GABA receptor complex (similar to benzodiazepines, nonbenzodiazepines and barbiturates).
Forms Supplied
Liquid: 100 mg/mL
Comments
Oral absorption may vary considerably, particularly in infants in whom absorption may be delayed (>60 min.).
Chloral hydrate is generally considered a safe drug but deaths due to respiratory depression have occurred in patients who received high doses or a second dose of chloral hydrate or an opioid or other sedative to increase depth of sedation.
Resedation after discharge due to long duration of action (2-4 hours) has been described.
Tolerance to sedative effects develops with regular use. Avoid regular use in patients with moderate to severe renal impairment.
Gradual dose tapering (e.g. 10% dose reduction every 1-2 days) is recommended after prolonged use (> 2 weeks) to prevent withdrawal symptoms (paradoxical agitation, anxiety, tremor)
May cause gastric irritation (dilute in water, fruit juice or ginger ale to minimize), excitement, delirium, prolonged sedation.
May induce hepatic enzymes and increase metabolism of other drugs.
May cause QTc prolongation and arrhythmia in overdose.
Oral liquid can be given by rectal route.
Chloral hydrate is generally considered a safe drug but deaths due to respiratory depression have occurred in patients who received high doses or a second dose of chloral hydrate or an opioid or other sedative to increase depth of sedation.
Resedation after discharge due to long duration of action (2-4 hours) has been described.
Tolerance to sedative effects develops with regular use. Avoid regular use in patients with moderate to severe renal impairment.
Gradual dose tapering (e.g. 10% dose reduction every 1-2 days) is recommended after prolonged use (> 2 weeks) to prevent withdrawal symptoms (paradoxical agitation, anxiety, tremor)
May cause gastric irritation (dilute in water, fruit juice or ginger ale to minimize), excitement, delirium, prolonged sedation.
May induce hepatic enzymes and increase metabolism of other drugs.
May cause QTc prolongation and arrhythmia in overdose.
Oral liquid can be given by rectal route.
References
44, 83, 577, 578
Last Edited
2022-06-16 00:34:29