Chloral Hydrate
Overview
Chloral hydrate is an older sedative and hypnotic medication. In modern paediatric medicine, it is primarily used for short-term sedation before diagnostic procedures, such as MRI or EEG scans.
Mechanism of Action
The exact mechanism is not fully understood, but it is believed to be converted into its active metabolite, trichloroethanol, which depresses the central nervous system, producing sedation and sleep without significantly affecting pain perception.
Dosage and Administration
Administered orally or rectally, usually 30 to 60 minutes before the scheduled procedure. The dosage is strictly calculated based on the child’s body weight, typically ranging from 25 to 50 mg/kg.
Side Effects
Common side effects include gastrointestinal irritation, nausea, and vomiting. It has a narrow therapeutic index, meaning overdoses can lead to severe respiratory depression, cardiac arrhythmias, and coma.
Contraindications
Contraindicated in patients with severe hepatic or renal impairment, severe cardiac disease, or a history of idiosyncratic reactions to the drug.
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