Noctec (Chloral Hydrate) Drug Information: Clinical Pharmacology

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May 27, 2012

Noctec

Sleep Disorder Drugs »

Sleep disorder drugs (hypnotic and sedative drugs) overview

Insomnia, a disorder of sleep, occurs occasionally in most people but usually lasts only a few days. The body then "corrects" itself naturally, and people return to a normal pattern of sleep. Insomnia may be short-term (less than three weeks) or chronic, lasting longer than three weeks. Contributing factors include, but are not limited to, poor sleeping habits, stress, jet lag, medications, disease, and depression. Chronic insomnia may warrant the use of sedative/hypnotics medications; however, it is important that the treating physician perform a complete diagnostic evaluation as well as take medication and substance abuse histories, to exclude secondary insomnia due to other conditions.

Hypnotics/sedatives medications (henceforth referred to as hypnotics) work, in general, by increasing the activity of gamma-aminobutyric acid (GABA), a neurotransmitter in the brain. Neuro...

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CLINICAL PHARMACOLOGY

The mechanism of action by which the Central Nervous System (CNS) is affected is not known. Chloral hydrate is readily absorbed from the gastrointestinal tract following oral administration; however, significant amounts of chloral hydrate have not been detected in the blood after oral administration. It is generally believed that the central depressant effects are due to the principal pharmacologically active metabolite trichloroethanol, which has a plasma half- life of 8 to 10 hours. A portion of the drug is oxidized to trichloroacetic acid (TCA) in the liver and kidneys; TCA is excreted in the urine and bile along with trichloroethanol in free or conjugated form.

Hypnotic dosage produces mild cerebral depression and quiet, deep sleep with little or no ''hangover''; blood pressure and respiration are depressed only slightly more than in normal sleep and reflexes are not significantly depressed, so the patient can be awakened and completely aroused. Chloral hydrate's effect on rapid eye movement (REM) sleep is uncertain. Chloral hydrate has been detected in cerebrospinal fluid and human milk, and it crosses the placental barrier.

Last reviewed on RxList: 12/8/2004
This monograph has been modified to include the generic and brand name in many instances.