chloral hydrate

Action and Spectrum

Actions and Spectrum 

As it reduces brain and spinal cord activity, chloral hydrate predominantly has a depressive effect on the central nervous system. GABA is an inhibitory neurotransmitter that helps control neuronal activity. 

chloral hydrate has a wide range of effects, including sedative, hypnotic, anxiolytic (anti-anxiety), and anticonvulsant properties.

Drug Interaction

Adverse Reaction

Frequency not defined  

Cardiovascular: Atrial arrhythmia, hypotension, shortening of refractory periods, depression of myocardial contractility 

Gastrointestinal: Diarrhea, nausea, vomiting, flatulence, gastric irritation 

Hematologic and oncologic: Acute porphyria, leukopenia, eosinophilia 

Ophthalmic: Allergic conjunctivitis, blepharoptosis, keratoconjunctivitis 

Dermatologic: Skin rash 

Otic: Increased middle ear pressure  

Respiratory: Airway obstruction (young children), laryngeal edema (children) 

Central nervous system: Abnormal gait, ataxia, confusion, hallucinations, hangover effect, malaise, nightmares, delirium, dizziness, drowsiness, drug dependence 

Endocrine and metabolic: Acute porphyria, ketonuria 

Black Box Warning

Black Box Warning 

None

Contraindication / Caution

Contraindication/Caution: 

Contraindication: 

• Individuals with a known hypersensitivity or allergy to chloral hydrate should not use the medication. 

Caution: 

• chloral hydrate should be used with caution in individuals with respiratory impairment, such as chronic obstructive pulmonary disease (COPD) 
• chloral hydrate should be used with caution in elderly or debilitated patients due to an increased risk of adverse effects.  
• Individuals with a history of alcohol should use chloral hydrate with caution. 
• Patients in long-term care, elderly, and newborns should all be treated with caution. 

Pregnancy / Lactation

Pregnancy consideration: 

Pregnancy category: N/A 

Lactation: It present into human milk  

Pregnancy Categories:         

Category A: well-controlled and Satisfactory studies show no risk to the fetus in the first or later trimester. 

Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women.  

Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women. 

Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits. 

Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women. 

Category N: There is no data available for the drug under this category. 

Pharmacology

Pharmacology  

Trichloroethanol is the active metabolite responsible for the pharmacological effects of chloral hydrate. 

Trichloroethanol acts primarily as a central nervous system depressant. It enhances the inhibitory effects of gamma-aminobutyric acid (GABA), an inhibitory neurotransmitter in the brain.  

Pharmacodynamics 

GABA is the major inhibitory neurotransmitter in the central nervous system. By enhancing the effects of GABA, chloral hydrate increases the opening frequency of GABA-gated chloride channels. 

Pharmacokinetics 

Absorption   

Its absorption occurs in the gastrointestinal tract after oral administration.  

Distribution 

It distributes throughout the body. 

Metabolism 

chloral hydrate is metabolized in the liver through the enzyme alcohol dehydrogenase.  

Elimination and excretion 

The metabolites of chloral hydrate are excreted primarily in the urine.

Adminstartion

Administration 

chloral hydrate is administered orally in the form of a syrup (solution) and capsule.

Patient Information Leaflet

Patient information leaflet 

Generic Name: chloral hydrate 

Why do we use chloral hydrate? 

chloral hydrate was commonly used as a sedative to induce sleep or relaxation in patients.  

chloral hydrate has been used in pediatric settings to facilitate sedation for diagnostic procedures, such as imaging studies.