Clonidine and Oxymetazoline toxicity
- Both drugs are centrally acting α₁-blockers that cause depressed mental status, bradycardia, hypotension, and miosis
- 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
- Most children with clonidine or oxymetazoline toxicity will be treated as if they had opioid toxicity, and vice versa
- 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
