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