Cardiovascular Medicine Book

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Clonidine Overdose

Aka: Clonidine Overdose, Clonidine Toxicity
  1. See Also
    1. Clonidine
    2. Drug Overdose
  2. Signs and Symptoms
    1. Apnea
    2. Bradycardia
    3. Coma
    4. Hypertension or Hypotension
    5. Hypothermia
    6. Mental status change
    7. Pinpoint pupils (Miosis)
  3. Management: Adults
    1. Naloxone
      1. Initial
        1. No respiratory depression: 0.1 to 0.4 mg IV or IM
        2. Respiratory depression: 1 to 2 mg IV or IM
      2. Next, if no response or incomplete response
        1. Give 2 mg IV or IM every 3-5 minutes to a total of 10-20 mg
    2. Atropine 0.5 to 1 mg IV
    3. Dopamine 5-20 mcg/kg/minute
      1. Start low and titrate for effect
  4. Management: Children
    1. Naloxone
      1. Initial
        1. No respiratory depression: 0.1 mg/kg to 0.4 mg IV or IM
        2. Respiratory depression: 1 to 2 mg IV or IM
      2. Next, if no response or incomplete response
        1. Give 2 mg IV or IM every 3-5 minutes to a total of 10-20 mg
    2. Atropine 0.02 mg/kg up to 0.16 mg IV
    3. Dopamine 5-20 mcg/kg/minute
      1. Start low and titrate for effect
      2. Add Norepinephrine if not responding to Dopamine at max dose
  5. References
    1. Seger (2002) J Toxicol Clin Toxicol 40(2): 145-55 [PubMed]

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