Critical care for clonidine poisoning in toddlers.
Clonidine may be a source of serious toxicity when ingested by toddlers. We describe 11 cases of clonidine ingestion by toddlers (mean dose 0.15 mg/kg; range 0.01 to 0.57). The source of the clonidine was a grand-parent in six of 11 cases. Symptoms included altered level of consciousness (n = 11), miosis (n = 5), bradycardia (n = 8), hypotension (n = 5), apnea and respiratory depression (n = 6), hypothermia (n = 5) and hypertension (n = 3). Therapeutic interventions included naloxone (n = 8) and atropine (n = 4), dopamine (n = 1), fluid resuscitation (n = 4), and endotracheal intubation (n = 1). There were no deaths. Symptoms of clonidine ingestion were typically mild if the dose ingested was less than 0.01 mg/kg, while bradycardia and hypotension occurred usually with doses of greater than 0.01 mg/kg. Apnea and respiratory depression were common when the dose exceeded 0.02 mg/kg. More effective measures are needed to prevent these potentially serious intoxications.
Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock.
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D001285:Atropine / Q000627:therapeutic use; D002675:Child, Preschool; D003000:Clonidine / Q000506:poisoning*; D003243:Consciousness; D003422:Critical Care; D004298:Dopamine / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D005260:Female; D005440:Fluid Therapy; D006801:Humans; D007223:Infant; D007902:Length of Stay; D008297:Male; D009270:Naloxone / Q000627:therapeutic use; D011041:Poisoning / Q000188:drug therapy / Q000503:physiopathology / Q000628:therapy*; D012151:Resuscitation; D012189:Retrospective Studies
D009270:Naloxone; D001285:Atropine; D003000:Clonidine; D004298:Dopamine