Clonidine Overdose

WHY IT MATTERS:

--Clonidine is a common medication in many households, adults are taking it, children can get into it, with minimal amounts causing sedation and AMS. 

MECHANISM:

--alpha-2 agonist

SYMPTOMS:
--respiratory depression
--miosis (small pupils)
--bradycardia
--hypotension
--somnolence

TREATMENT:
--Symptoms usually resolve in 24 hours; deaths are rare with most treatment being supportive care.   
--Naloxone can reverse this in some cases and is worth a try in opioid naive children. Use between 0.4mg to 10mg with larger doses for evaluation of any effect.


10-SECOND RECAP:
--clonidine overdose can happen
--its an alpha-2 agonist
--looks a bit like opiate toxidrome (sleepy, respiratory depression, small pupils, etc.)
--narcan/naloxone might be worth a try (0.4mg IV and more PRN, titrate to effect)

Submitted by T. Boyd.

Reference(s): Goldfrank’s Toxicologic Emergencies 8th ed. page 948-9, picture