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Critical care for clonidine poisoning in toddlers
D H Fiser1, M M Moss, W Walker
1Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock.
Insights
Clonidine ingestion in toddlers can cause serious toxicity, including altered consciousness and respiratory depression. Doses over 0.01 mg/kg increase risks, highlighting the need for better prevention strategies.
Area of Science:
- Pediatric Toxicology
- Clinical Pharmacology
Background:
- Clonidine, an antihypertensive medication, poses a risk of significant toxicity when ingested by young children.
- Accidental ingestion by toddlers, often from household sources like grandparent's medication, is a concern.
Abstract:
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.