clonidine poisoning in a child-a case report

Introduction: clonidine is among the drugs that are in a list of ‘one pill can kill’ drugs. we are reporting a child with clonidine toxicity with classical manifestations who recovered completely. case report: a 3 year and 2 months old adhd girl presented with drowsiness for 30 minutes. her mother gave the history of accidental consumption of 3/4th clonidine 100 mcg tablet 45 minutes prior. on the examination, the child was drowsy with glasgow coma score (gcs) 12/15. her heart rate was 82 /minute with low volume pulse, respiratory rate 22 /minute, systolic blood pressure was 80 mm of hg, and diastolic bp was not recordable. immediately normal saline bolus was administered and her pulse volume improved and bp was 94/60 mm of hg. after an hour, gcs was 9/15 and the respiration was shallow. after 4 hours, her sensorium improved (gcs 15/15). by 6 hours of ingestion, the child showed complete recovery. discussion: most of the clonidine poisoning children were younger than 6 years according to the nswpic database. among them, 60% developed symptoms, most commonly lethargy (80%), bradycardia (17%), hypotension (15%), and respiratory depression (5%). symptoms usually develop within 30-60 minutes and resolve within 24-48 hours. in our case, classical symptoms like drowsiness, hypotension, meiosis occurred within 30 minutes of ingestion and her consciousness deteriorated along with shallow respiration by the next 2 hours. by 6 hours of ingestion, the child showed complete recovery. conclusion: while prescribing clonidine caution should be exercised regarding the side-effects. when calculating the dose, extra vigilance should be ensured and drug needs to be kept out of the reach of children.