(1989; 60 pages) [French]
Syrup: 200 mg in 5 ml
Chloral hydrate is a sedative and hypnotic. The depressant effect on the central nervous system is believed to be due to an active metabolite, trichloroethanol. Its mechanism of action is unknown.
Chloral hydrate is rapidly absorbed from the gastrointestinal tract following oral or rectal administration. The depressant effect, which is evident within 30 minutes to 1 hour, persists for 6 to 8 hours. It is metabolized in the liver to the active metabolite trichloroethanol, which is subsequently excreted in the urine. The plasma half-life is 7 to 10 hours.
Preoperative medication to allay anxiety and to produce sedation.
Dosage and administration
Adults and children: 30 mg/kg 30 minutes before surgery.
• Known hypersensitivity to chloral hydrate.
• Hepatic or renal impairment.
The dosage should be reduced in patients with cardiac disease.
Ambulatory patients should be warned that chloral hydrate may impair their ability to drive or operate machinery for up to 24 hours.
Use in pregnancy
Chloral hydrate should be used during pregnancy only when the need outweighs any potential risk to the fetus.
Gastric irritation is the most frequent adverse effect. Skin rashes may also occur.
The hypoprothrombinaemic effect of coumarin anticoagulants may be intensified if such drugs are given concurrently with chloral hydrate.
Signs of overdose include increasing confusion, severe drowsiness leading to coma, hypotension, hypothermia and respiratory depression.
Induction of emesis or gastric lavage may be of value if undertaken within a few hours of ingestion. Otherwise, reliance must be placed on supportive measures such as maintenance of circulatory volume and mechanically assisted respiration.
Chloral hydrate syrup should be stored in tightly closed containers protected from light, below 25°C.