摘要
Objectives: We performed a prospective case series to seek dosage or clinical parameters to better identify patients who need direct medical evaluation.Study design: All clonidine ingestions in children younger than 12 years of age reported to 6 poison centers were followed for a minimum of 24 hours.Exclusion criterion was polydrug ingestion.Results: The study included 113 patients, of whom 63 were male.Mean age was 3.8 years (±2.4 SD).Clinical effects were common, but severe adverse effects occurred in <10%of patients.The dose ingested was reported for 90 patients (80%); 61 (68%) children ingested <0.3 mg and none had coma, respiratory depression, or hypotension.The lowest dose ingested by history with coma and respiratory depression was 0.3 mg (0.015 mg/kg).Prior clonidine therapy did not affect outcome.Onset of full clinical effects in all cases was complete within 4 hours of ingestion.Conclusions: We recommend direct medical evaluation for (1) all children 4 years of age and younger with unintentional clonidine ingestion of ≥0.1 mg, (2) ingestion of >0.2 mg in children 5 to 8 years of age, and (3) ingestion of ≥0.4 mg in children older than 8 years of age.Observation for 4 hours may be sufficient to detect patients who will develop severe effects.
Objectives: We performed a prospective case series to seek dosage or clinical parameters to better identify patients who need direct medical evaluation.Study design: All clonidine ingestions in children younger than 12 years of age reported to 6 poison centers were followed for a minimum of 24 hours.Exclusion criterion was polydrug ingestion.Results: The study included 113 patients, of whom 63 were male.Mean age was 3.8 years (±2.4 SD).Clinical effects were common, but severe adverse effects occurred in <10%of patients.The dose ingested was reported for 90 patients (80%); 61 (68%) children ingested <0.3 mg and none had coma, respiratory depression, or hypotension.The lowest dose ingested by history with coma and respiratory depression was 0.3 mg (0.015 mg/kg).Prior clonidine therapy did not affect outcome.Onset of full clinical effects in all cases was complete within 4 hours of ingestion.Conclusions: We recommend direct medical evaluation for (1) all children 4 years of age and younger with unintentional clonidine ingestion of ≥0.1 mg, (2) ingestion of >0.2 mg in children 5 to 8 years of age, and (3) ingestion of ≥0.4 mg in children older than 8 years of age.Observation for 4 hours may be sufficient to detect patients who will develop severe effects.
