Disclaimer to the Online Edition
This Manual has been designed for use in the NICU at London Health Sciences Centre (LHSC), London, Ontario, Canada, and represents clinical practice at this institution. The information contained within the Manual may not be applicable to other centres. If users of this Manual are not familiar with a drug, it is recommended that the official monograph be consulted before it is prescribed and administered. Any user of this information is advised that the contributors, Editor and LHSC are not responsible for any errors or omissions, and / or any consequences arising from the use of the information in this Manual.
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