chloral hydrate
Indication
- For use as a short-term sedative (less than 2 weeks)
- Sedative/hypnotic prior to diagnostic procedures
Dosage Guidelines
- Sedation (agitation): 10-15 mg/kg/dose oral/rectal q6-8 hours as needed
- Sedation (pre-procedure): 50-75 mg/kg/dose oral/rectal. Give 30 to 60 minutes prior to procedure. May repeat in 30 minutes x 1 dose to a maximum of 120 mg/kg total or 500 mg total
Administration
- Oral: Mix with feeds to minimize gastric irritation
- Rectal: Dilute 1:1 with sterile water for injection
Adverse Effects
- Gastric irritation, vomiting, diarrhea, paradoxical excitement and hypotension
- CNS, myocardial and respiratory depression
- Rarely, ketonuria, leucopenia and eosinophilia
- Prolonged use may result in direct hyperbilirubinemia
Comments
- For oral route, onset within 20 minutes. Maximum effect 30 to 60 minutes
- Avoid oral route in gastritis and gastric duodenal ulcers
- Drug interactions:
- CNS depressants: additive CNS depression
- Furosemide IV in patients with cardiac disease: diaphoresis, flushing and changes in BP within 24 hours of administration
- Avoid use in patients with severe renal or hepatic impairment
- Not recommended for extended routine sedation in neonates due to the possibility of accumulation of toxic metabolites
Supplied As
- 100 mg/mL oral liquid
References
LexiComp Pediatric and Neonatal, LexiComp Sick Kids