PEDIATRICS Vol. 72 No. 4 October 1983, pp. 500-502
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Massive Clonidine Ingestion with Hypertension in a 9-Month-Old Infant

Pablo Yagupsky MD1 and Rafael Gorodischer MD1

1 From the Department of Pediatrics "A," Soroka University Hospital and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheba, Israel

The antihypertensive drug clonidine has a double and antagonistic effect on arterial blood pressure. As a result of activation of peripheral agr-adrenergic receptors, it causes a transient increase in blood pressure; by a central action it decreases sympathetic tone which results in sustained bradycardia and hypotension. Both central and peripheral effects are experimentally blocked by tolazoline, an agr-adrenergic blocking agent. The toxic symptoms seen in clonidine poisoning are usually produced by the central effect. A case of severe clonidine poisoning in a 9-month-old infant is reported. The clinical picture included coma, miosis, apneic spells, bradycardia, and hypertension. Rapid and complete recovery was obtained with supportive treatment that included assisted ventilation. No adrenergic blockers or antihypertensive drugs were given. Use of tolazoline in cases of clonidine overdose in children remains controversial. Supportive measures alone may be adequate for even the most severe cases.

Key Words: clonidine • bradycardia • hypotension • agr-adrenergic receptors

Accepted on December 8, 1982