Chloral hydrate was first utilized in 1869 by Liebrich, who reported the initial cases of acute and chronic poisonings in 1890. Chloral hydrate is readily absorbed following oral administration. Today chloral hydrate is frequently used in the pediatric and elderly population for sedation. Oral preparations are prescribed for short-term sedation and surgical and radiological premedication. Following chloral hydrate administration, cardiac arrhythmias are reported in the literature in both adults and children.
Chloral hydrate has a narrow therapeutic range.
Thus it can lead to serious and possibly fatal consequences in cases of intentional or accidental overdose. The mechanism of action of chloral hydrate is largely unknown. Chloral hydrate is readily absorbed from the gastrointestinal tract and metabolized by the liver enzyme alcohol dehydrogenase to trichloroethanol. Significant amounts of the parent compound are not found in the blood after its oral administration. The drug is converted in the liver and kidney to trichloroacetic acid and excreted in the urine and bile.