Clonidine toxicity

Revision as of 16:22, 22 March 2016 by Ostermayer (talk | contribs) (Text replacement - "Category:Tox" to "Category:Toxicology")
2D molecular structure of Clonidine

Background

  • Alpha-2 and opioid receptor agonist

Clinical Features

  • Cardiac
    • Bradycardia
    • Hypotension
  • Neuro
    • Lethargy (may progress to apnea)
    • Miotic pupils

Differential Diagnosis

Toxidrome Chart

Finding Cholinergic Anticholinergic Sympathomimetic Sympatholytic^ Sedative/Hypnotic
Example Organophosphates TCAs Cocaine Clonidine ETOH
Temp Nl Nl / ↑ Nl / ↑ Nl / ↓ Nl / ↓
RR Variable Nl / ↓ Variable Nl / ↓ Nl / ↓
HR Variable ↑ (sig) Nl / ↓ Nl / ↓
BP Nl / ↓ Nl / ↓
LOC Nl / Lethargic Nl, agitated, psychotic, comatose Nl, agitated, psychotic Nl, Lethargic, or Comatose Nl, Lethargic, or Comatose
Pupils Variable Mydriatic Mydriatic Nl / Miotic
Motor Fasciculations, Flacid Paralysis  Nl Nl / Agitated Nl
Skin Sweating (sig) Hot, dry Sweating Dry
Lungs Bronchospasm / rhinorrhea Nl Nl Nl
Bowel Sounds Hyperactive (SLUDGE) ↓ / Absent Nl / ↓ Nl / ↓
^Consider Sympatholytic when looking at Sedative OD or someone who doesn't respond to Narcan
Withdrawal from substances have the opposite effect

Diagnosis

Treatment

  • Respiratory/neuro depression
    • Naloxone
      • High dose may be required (up to 10mg)
      • Not always effective
  • Bradycardia
    • Atropine
  • Hypotension
    • IVF

Source

  • Tintinalli

See Also

Toxicology (Main)