Clonidine and Oxymetazoline toxicity

Clonidine and Oxymetazoline toxicity

  1. Both drugs are centrally acting α₁-blockers that cause depressed mental status, bradycardia, hypotension, and miosis
  2. Partial response to naloxone is common
    • No easy or consistent way to differentiate from opioid toxicity
    • Urine test for these drugs is typically available only at reference laboratories
      • Results will not change patient management
  3. Most children with clonidine or oxymetazoline toxicity will be treated as if they had opioid toxicity, and vice versa
  4. Nonresponse to naloxone is the best way to determine that the diagnosis is likely something other than opioid toxicity, but eliciting a response in patients with opioid toxicity may require large doses of naloxone
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