title: Clonidine as an adjuvant in the management of acute poisoning by anticholinesterase pesticides.
abstract: BACKGROUND
  Anticholinesterase pesticides are widely used in agriculture and domestic settings throughout the world, and they are responsible for great morbidity and mortality. In Egypt and other developing countries, there is a pressing need for new affordable antidotes to treat anticholinesterase pesticide poisoning. Hence, this study was conducted to evaluate the safety and effectiveness of moderate doses of clonidine in the management of adult patients with acute anticholinesterase pesticide poisoning.
  
  
  METHODS
  This study was an open-label, phase II pilot clinical trial. Sixty patients with acute anticholinesterase pesticide poisoning gave consent to participate in the study. They were divided into 2 equal groups, with 30 patients in each group. Group I received clonidine plus the routine treatment, while group II received only the routine treatment. Patients were subjected to full history taking, and their vital and clinical data were recorded. Serum cholinesterase levels and routine laboratory investigations were measured. The different outcomes of the patients were assessed.
  
  
  RESULTS
  The baseline characteristics of both groups were similar. Thirteen (43.3%) patients developed significant hypotension during clonidine treatment. The clinical outcomes (including mortality, need for assisted ventilation, length of hospital stay, and total doses of atropine) showed no significant differences between the two groups.
  
  
  CONCLUSIONS
  The use of clonidine in acute anticholinesterase pesticide poisoning may be associated with a high incidence of hypotension requiring intervention. The clinical outcomes may not significantly improve in clonidine-treated patients.
authors.affiliation: Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Tanta University, Tanta, Egypt a.ebiary@gmail.com.
authors.forename: A A
authors.initials: AA
authors.lastname: El-Ebiary
authors.affiliation: Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Tanta University, Tanta, Egypt.
authors.forename: S A
authors.initials: SA
authors.lastname: Gad
authors.affiliation: Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Tanta University, Tanta, Egypt.
authors.forename: A A
authors.initials: AA
authors.lastname: Wahdan
authors.affiliation: Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Tanta University, Tanta, Egypt.
authors.forename: I H
authors.initials: IH
authors.lastname: El-Mehallawi
mesh_terms: D000293:Adolescent; D058647:Adrenergic alpha-2 Receptor Agonists / Q000008:administration & dosage / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000931:Antidotes / Q000008:administration & dosage / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D002800:Cholinesterase Inhibitors / Q000506:poisoning*; D003000:Clonidine / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010575:Pesticides / Q000506:poisoning*; D010865:Pilot Projects; D055815:Young Adult
chemical_list: D058647:Adrenergic alpha-2 Receptor Agonists; D000931:Antidotes; D002800:Cholinesterase Inhibitors; D010575:Pesticides; D003000:Clonidine
keywords: Anticholinesterase; clonidine; pesticides; poisoning