Clonidine and other central alpha-2 agonists: can one pill kill a toddler?

3 out of 5 stars Unintentional Pediatric Exposures to Central Alpha-2 Agonists Reported to the National Poison Data System. Wang GS et al. J Pediatr 2013 Oc 1 [Epub ahead of print] Abstract Central alpha-2 agonists — clonidine, guanfacine, and tizanidine — are increasingly being used for approved and off-label indications, including hypertension, muscle spasms, tics, and opioid withdrawal. Extended-release forms of guanfacine (Intuniv) and clonidine (Kapvay) have been approved for treatment of attention-deficit hyperactivity disorder (ADHD). These drugs are selective agonists at the central presynaptic alpha-2 adrenergic receptors. They decrease catecholamine release and sympathetic tone. Adverse effects include CNS depression, bradycardia, and hypotension. Some chapters and review articles suggest that clonidine should be included in the list of drugs that have potential to kill a toddler after ingestion of a single pill. The authors of this paper retrospectively reviewed data from the National Poison Data System (NPDS) from January 2000 through December 2011 to identify cases of single-agent unintentional exposure to clonidine, guanfacine, or tizanidine in children aged 12 years or less. The authors identified approximately 28,000 cases of clonidine exposure, 6000 guanfacine exposures, and 900 tizanadine exposures. There was a trend towards an increased proportion of these cases, consistent with the approval of alpha-2 agonists for treatment of ADHD. Major ...
Source: The Poison Review - Category: Toxicology Authors: Tags: Medical central alpha-2 agonist clonidine guanfacine intuniv kapvay kill one pill pediatric tizanidine Source Type: news

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