TESS-based dose-response using pediatric clonidine exposures.
OBJECTIVE
The toxic and lethal doses of clonidine in children are unclear. This study was designed to determine whether data from the American Association of Poison Control Centers Toxic Exposure Surveillance System (TESS) could be utilized to determine a dose-response relationship for pediatric clonidine exposure.


METHODS
3,458 single-substance clonidine exposures in children <6 years of age reported to TESS from January 2000 through December 2003 were examined. Dose ingested, age, and medical outcome were available for 1550 cases. Respiratory arrest cases (n = 8) were classified as the most severe of the medical outcome categories (Arrest, Major, Moderate, Mild, and No effect). Exposures reported as a "taste or lick" (n = 51) were included as a dose of 1/10 of the dosage form involved. Dose ranged from 0.4 to 1980 (median 13) microg/kg. Weight was imputed based on a quadratic estimate of weight for age. Dose certainty was coded as exact (26% of cases) or not exact (74%). Medical outcome (response) was examined via logistic regression using SAS JMP (release 5.1).


RESULTS
The logistic model describing medical outcome (P < 0.0001) included Log dose/kg (P = 0.0000) and Certainty (P = 0.045).


CONCLUSIONS
TESS data can provide the basis for a statistically sound description of dose-response for pediatric clonidine poisoning exposures.
Benson
Blaine E
BE
New Mexico Poison and Drug Information Center and University of New Mexico College of Pharmacy, Albuquerque, 87131, USA. jebenson@salud.unm.edu
Spyker
Daniel A
DA
Troutman
William G
WG
Watson
William A
WA
D000059:Accidents; D000316:Adrenergic alpha-Agonists / Q000506:poisoning*; D002675:Child, Preschool; D003000:Clonidine / Q000506:poisoning*; D003627:Data Interpretation, Statistical; D016208:Databases, Factual / Q000592:standards*; D004305:Dose-Response Relationship, Drug; D062787:Drug Overdose / Q000145:classification*; D006801:Humans; D007223:Infant; D016015:Logistic Models; D011039:Poison Control Centers / Q000592:standards*; D011159:Population Surveillance; D016016:Proportional Hazards Models; D012015:Reference Standards; D018570:Risk Assessment / Q000592:standards
D000316:Adrenergic alpha-Agonists; D003000:Clonidine