Clonidine toxicity

Q: Which of the following is recommended for clonidine toxicity?

A) Naloxone 
B) Tolazoline
C) Yohimbine
D) Hemodialysis
E) Beta-blocker


Answer: A

Naloxone is the only drug that has shown some benefit in clonidine toxicity particularly with central effect i.e, marked drowsiness or coma. Even data on Naloxone is limited. Clonidine toxicity is mostly managed as supportive treatment. In the past, alpha-adrenergic antagonists, tolazoline, and yohimbine have been suggested as antidotes but their side-effect profile is riskier than benefit of its use. Clonidine is not removed by hemodialysis. Clonidine itself can cause marked bradycardia and the use of beta-blocker would be potentially more harmful.

#pharmacology
#toxicology


References:

1. Seger DL, Loden JK. Naloxone reversal of clonidine toxicity: dose, dose, dose. Clin Toxicol (Phila) 2018; 56:873. 

2. Shannon M, Neuman MI. Yohimbine. Pediatr Emerg Care 2000; 16:49.

3. Gummin DD, Mowry JB, Spyker DA, et al. 2016 Annual Report of the American Association of Poison Control Centers' National Poison Data System (NPDS): 34th Annual Report. Clin Toxicol (Phila) 2017; 55:1072.