CATAPRES overdosage: Difference between revisions
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==Overdosage== | ==Overdosage== | ||
[[Hypertension]] may develop early and may be followed by [[hypotension]], [[bradycardia]], respiratory depression, [[hypothermia]], drowsiness, decreased or absent reflexes, weakness, irritability and [[miosis]]. The frequency of CNS depression may be higher in children than adults. Large overdoses may result in reversible cardiac conduction defects or [[dysrhythmias]], [[apnea]], [[coma]] and [[seizures]]. Signs and symptoms of overdose generally occur within 30 minutes to two hours after exposure. As little as 0.1 mg of clonidine has produced signs of toxicity in children. | |||
There is no specific antidote for clonidine overdosage. Clonidine overdosage may result in the rapid development of CNS depression; therefore, induction of vomiting with ipecac syrup is not recommended. Gastric lavage may be indicated following recent and/or large ingestions. Administration of activated charcoal and/or a cathartic may be beneficial. Supportive care may include atropine sulfate for [[bradycardia]], intravenous fluids and/or [[vasopressor]] agents for [[hypotension]] and [[vasodilators]] for [[hypertension]]. Naloxone may be a useful adjunct for the management of clonidine-induced respiratory depression, [[hypotension]] and/or coma; blood pressure should be monitored since the administration of [[naloxone]] has occasionally resulted in paradoxical hypertension. Dialysis is not likely to significantly enhance the elimination of clonidine. | |||
<ref name="dailymed.nlm.nih.gov">{{Cite web | last = | first = | title = CATAPRES (CLONIDINE HYDROCHLORIDE) TABLET [BOEHRINGER INGELHEIM PHARMACEUTICALS INC.] | url = http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=d7f569dc-6bed-42dc-9bec-940a9e6b090d | publisher = | date = | accessdate = 5 February 2014 }}</ref> | The largest overdose reported to date involved a 28-year old male who ingested 100 mg of clonidine hydrochloride powder. This patient developed hypertension followed by [[hypotension]], [[bradycardia]], [[apnea]], [[hallucinations]], semicoma, and premature ventricular contractions. The patient fully recovered after intensive treatment. Plasma clonidine levels were 60 ng/ml after 1 hour, 190 ng/ml after 1.5 hours, 370 ng/ml after 2 hours, and 120 ng/ml after 5.5 and 6.5 hours. In mice and rats, the oral LD50 of clonidine is 206 and 465 mg/kg, respectively.<ref name="dailymed.nlm.nih.gov">{{Cite web | last = | first = | title = CATAPRES (CLONIDINE HYDROCHLORIDE) TABLET [BOEHRINGER INGELHEIM PHARMACEUTICALS INC.] | url = http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=d7f569dc-6bed-42dc-9bec-940a9e6b090d | publisher = | date = | accessdate = 5 February 2014 }}</ref> | ||
==References== | ==References== | ||
Revision as of 05:36, 6 February 2014
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Pratik Bahekar, MBBS [2]
For patient information, click here.
Overdosage
Hypertension may develop early and may be followed by hypotension, bradycardia, respiratory depression, hypothermia, drowsiness, decreased or absent reflexes, weakness, irritability and miosis. The frequency of CNS depression may be higher in children than adults. Large overdoses may result in reversible cardiac conduction defects or dysrhythmias, apnea, coma and seizures. Signs and symptoms of overdose generally occur within 30 minutes to two hours after exposure. As little as 0.1 mg of clonidine has produced signs of toxicity in children.
There is no specific antidote for clonidine overdosage. Clonidine overdosage may result in the rapid development of CNS depression; therefore, induction of vomiting with ipecac syrup is not recommended. Gastric lavage may be indicated following recent and/or large ingestions. Administration of activated charcoal and/or a cathartic may be beneficial. Supportive care may include atropine sulfate for bradycardia, intravenous fluids and/or vasopressor agents for hypotension and vasodilators for hypertension. Naloxone may be a useful adjunct for the management of clonidine-induced respiratory depression, hypotension and/or coma; blood pressure should be monitored since the administration of naloxone has occasionally resulted in paradoxical hypertension. Dialysis is not likely to significantly enhance the elimination of clonidine.
The largest overdose reported to date involved a 28-year old male who ingested 100 mg of clonidine hydrochloride powder. This patient developed hypertension followed by hypotension, bradycardia, apnea, hallucinations, semicoma, and premature ventricular contractions. The patient fully recovered after intensive treatment. Plasma clonidine levels were 60 ng/ml after 1 hour, 190 ng/ml after 1.5 hours, 370 ng/ml after 2 hours, and 120 ng/ml after 5.5 and 6.5 hours. In mice and rats, the oral LD50 of clonidine is 206 and 465 mg/kg, respectively.[1]
References
- ↑ "CATAPRES (CLONIDINE HYDROCHLORIDE) TABLET [BOEHRINGER INGELHEIM PHARMACEUTICALS INC.]". Retrieved 5 February 2014.