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Hypertension associated with clonidine ingestion
Veterinary and Human Toxicology
|January 1, 1984
Summary
Accidental Clonidine hydrochloride (CH) ingestion in children can cause serious toxicity, including apnea, even with small doses. Prompt supportive care led to full recovery in all patients within hours.
Area of Science:
- Pediatric Toxicology
- Emergency Medicine
- Pharmacology
Background:
- Clonidine hydrochloride (CH) is an antihypertensive medication with complex alpha-adrenergic and CNS effects.
- Accidental ingestion of CH can lead to significant toxicity in pediatric patients.
Purpose of the Study:
- To review the clinical presentation and outcomes of pediatric patients admitted to the ICU after accidental Clonidine hydrochloride ingestion.
- To highlight the potential for severe toxicity from relatively small ingestions of CH.
Main Methods:
- Retrospective review of medical records for 5 children admitted to a Pediatric Intensive Care Unit (PICU) following accidental CH ingestion.
- Analysis of clinical signs, symptoms, ingested dose, treatment, and patient outcomes.
Main Results:
- All 5 patients presented with lethargy/stupor within 20-60 minutes post-ingestion.
- Four patients experienced respiratory depression or apnea, with 2 requiring intubation and 1 mechanical ventilation.
- Transient hypertension was observed in all patients; 3 developed asymptomatic bradycardia. Significant toxicity occurred despite estimated small ingestions (0.2-0.4 mg in 4/5 patients).
Conclusions:
- Apnea was the most critical adverse event observed following CH overdose in children.
- Even small ingestions of Clonidine hydrochloride can cause significant pediatric toxicity.
- Supportive care and GI decontamination were effective, with rapid resolution of toxicity and good patient outcomes.