Clonidine overdose in children

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  1. ennumka Well-Known Member

    Clonidine overdose in children


    Six cases of toxic ingestion of clonidine hydrochloride are reviewed. Apnea, respiratory depression, and rhythm disturbances were more frequent in our patients than in those previously reported; hypotension and bradycardia occrred at a similar frequency. Satisfactory management consisted of close attention to vital signs and judicious treatment of specific physiologic abnormalities. Tolazoline was found to be ineffective in reversing symptoms and signs of clonidine overdosage. Hypotension was managed by volume expansion, and if necessary, by a continuous infusion of dopamine. Naloxone, although not used in our patients, may be of both diagnostic and therapeutic value in treating clonidine overdosage. Provide aggressive supportive care because patients may rapidly decompensate. Address airway, breathing, and circulation (ABCs) as usual. Intravenous access with crystalloid and pressor support with dopamine may be necessary. If a clonidine patch is present on the skin, remove it and wash the exposed area. Initiate standard naloxone therapy and blood glucose checks. Clonidine toxicity can cause serious respiratory depression and apnea requiring immediate endotracheal intubation and mechanical ventilation. Once the airway is secure, place the patient on continuous ECG, blood pressure, and oxygen saturation monitoring. Consider central venous pressure (CVP) monitoring in patients who are markedly hypotensive. Hypotension is very common with clonidine toxicity; initially treat the patient with aggressive crystalloid infusion.

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    Clonidine overdose can cause significant CNS and CVS depression. Children are very susceptible to clonidine toxicity. Toxicity / Risk Assessment. Management. Learn about Catapres Clonidine may treat, uses, dosage, side effects, drug interactions. Because children commonly have gastrointestinal illnesses that lead to. Signs and symptoms of overdose generally occur within 30 minutes to two. Dec 15, 2017. While elucidating the amount and timing of the clonidine ingestion is helpful. In cases of possible clonidine toxicity involving children, always.

    While elucidating the amount and timing of the clonidine ingestion is helpful, in practice, signs and symptoms guide therapy. Always suspect other co-ingestants and screen appropriately. Children are particularly susceptible to toxic reaction from small doses (ie, normal adult therapeutic doses) of clonidine. The Catapres TTS patch appears similar to a small Band-Aid or sticker, and a child could pull the patch off a sleeping caretaker. Several case reports document patches detaching spontaneously from a sleeping parent in a bed shared with a child and subsequently adhering to the child with resultant toxicity. In cases of possible clonidine toxicity involving children, always question family, friends, and emergency medical services (EMS) as to whether a child may have had access to clonidine. Three patients who were receiving long-term treatment with intrathecal clonidine experienced a clonidine overdose because of inadvertent extravasation during the refilling procedure. All three patients experienced loss of consciousness and severe systemic hypertension that required aggressive parenteral treatment. At therapeutic doses (0.2-0.9 mg/d), clonidine is commonly associated with adverse effects such as dry mouth, sedation, dizziness, and constipation. While generally safe, at toxic doses clonidine can cause serious cardiopulmonary instability and central nervous system (CNS) depression in children and adults. Clonidine is available in a weekly transdermal patch (Catapres TTS: 0.1 mg, 0.2 mg, or 0.3 mg/d, with each patch containing 2.5 mg, 5 mg, and 7.5 mg of clonidine, respectively) and in tablet form (Catapres: 0.1 mg, 0.2 mg, and 0.3 mg; Combipres includes 15 mg of chlorthalidone diuretic). An ophthalmic solution is occasionally used in the treatment of glaucoma. Clonidine is an imidazole derivative and was first used as a nasal decongestant. Decongestants containing tetrahydrozoline, also an imidazole derivative, can result in the same signs and symptoms as clonidine poisoning when ingested, especially in children. Clonidine acts primarily as a presynaptic CNS alpha2-agonist, stimulating receptors in the nucleus tractus solitarii of the medulla oblongata.

    Clonidine overdose in children

    A 1000-Fold Overdose of Clonidine Caused by a Compounding Error., Catapres Clonidine Side Effects, Interactions, Warning, Dosage.

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  7. Dec 15, 2017. Clonidine is a central alpha-agonist that is used as an antihypertensive agent. symptoms as clonidine poisoning when ingested, especially in children. transient vasoconstriction and hypertension early in overdose when.

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    Ber of reports of patients with clonidine overdose requir- ing endotracheal intubation, however, these children had ingestions of unknown amounts or doses. Request PDF on ResearchGate Clonidine overdose in childhood Implications24.89. Children's Hospital at Westmead. Cases of clonidine overdose were identified by review of the emergency department attendance register, the intensive care unit database and inpatient statistics collection. Jul 20, 2018. Clonidine poisoning may occur from exploratory ingestion by young children, transdermal exposure from a clonidine patch, malicious drug.

     
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