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Toxic clonidine ingestion in children
Henry A Spiller1, Wendy Klein-Schwartz, Jonathan M Colvin
1Kentucky Regional Poison Center, Louisville, Kentucky 40232-5070, USA.
The Journal of Pediatrics
|February 4, 2005
Summary
Clonidine ingestion in children requires medical evaluation based on age and dose. Doses of 0.1 mg or more for younger children, 0.2 mg for mid-age, and 0.4 mg for older children warrant assessment. Severe effects typically appear within 4 hours.
Area of Science:
- Pediatric Toxicology
- Clinical Pharmacology
Background:
- Clonidine is a medication with potential for toxicity in pediatric ingestions.
- Identifying clear parameters for medical evaluation after clonidine ingestion is crucial for patient management.
Purpose of the Study:
- To establish dosage and clinical parameters for identifying children requiring direct medical evaluation after clonidine ingestion.
- To refine guidelines for managing pediatric clonidine exposures.
Main Methods:
- A prospective case series involving 113 children under 12 years old who ingested clonidine.
- Data collected from 6 poison centers, excluding polydrug ingestions, with a minimum 24-hour follow-up.
Main Results:
- Severe adverse effects were uncommon (<10%).
- Children ingesting less than 0.3 mg rarely experienced severe symptoms like coma, respiratory depression, or hypotension.
- The onset of clinical effects was consistently within 4 hours post-ingestion.
Conclusions:
- Recommends direct medical evaluation for specific clonidine ingestion amounts based on age groups: - ≥0.1 mg for children ≤4 years - >0.2 mg for children 5-8 years - ≥0.4 mg for children >8 years
- A 4-hour observation period is suggested to identify patients likely to develop severe effects.