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Chloral Hydrate/Noctec

- for insomnia, used as a sedatvie especially in children; also use as preoperative sedative; sedative hypnotic, non barbiturate;
- Adult: 500mg-1gm PO or PR qhs prn (max 2gm/day);
- Causes gastric and mucosal irritation;
- Contraindicated with marked hepatic or renal impairment, or with severe cardiac disease;
- Use with caution w/concomitant oral anticoagulant use (will potentiate anticoagulant effect when chloral hydrate is stopped);
- abrupt withdrawl of this drug may result in delirium;
- Peds: Sedative: 5-25 mg/kg/dose given tid prn PO/PR; Hypnotic:   50 mmg/kg/dose
- Hypnotic: 20-40 mg/kg/dose q4-8 hrs;
- Maximum 50 mg/kg/dose or max 1 gm/dose PO/PR;
- chloral hydrate may be a useful hypnotic for the older patient;
- it seldom produces delirium, has little habituation potential, and exerts little adverse effect on normal sleep cycles.
- Drug Interactions:
    - acidic drugs as warfarin and diphenylhydantoin from plasma proteins;
    - may thus induce a sudden increase in the free (unbound) concentrations of such displaced drugs, transiently increase effects of those drugs, reduce their total plasma concentration, and shorten their elimination half-lives;
- Supplied: cap 250, 500 mg; susp 500 mg/5 cc; suppos 600 mg