Rocky Mountain Poison and Drug Center, Denver Health, Denver, CO.
Rocky Mountain Poison and Drug Center, Denver Health, Denver, CO.
J Pediatr. 2014 Jan;164(1):149-52. doi: 10.1016/j.jpeds.2013.08.038. Epub 2013 Oct 1.
To investigate national trends in unintentional pediatric exposures to 3 common alpha-2 agonists: clonidine, guanfacine, and tizanidine. Secondary objectives were to describe outcomes, symptoms, treatments, and death.
Retrospective chart review from the American Association of Poison Control Centers National Poison Data System from January 2000 to December 2011 for unintentional exposure to clonidine, guanfacine, and tizanidine in children ≤ 12 years of age.
From 2000-2011, there was a significant increase (5.9% per year, CI 3.6, 8.2) in unintentional pediatric exposures to National Poison Data System for central alpha-2 agonists. There were 27,825 clonidine exposures (67.3% male, median age: 4 years), 6143 guanfacine exposures (69.8% male, median age: 6 years), and 856 tizanidine exposures (51.9% male, median age: 2 years). Guanfacine had the greatest proportional increase among the medications. Clonidine was associated with the most respiratory (799, 2.9%) and central nervous system symptoms (12,612, 45.3%), as well as the most episodes of bradycardia (2847, 10.2%) and hypotension (2365, 8.5%). Seven-hundred twenty-eight (2.0%) patients were intubated, and 141 patients (0.5%) were administered vasopressors. There were 7 cardiac arrests and 3 deaths from clonidine.
The number of unintentional pediatric exposures to alpha-2 agonists increased from 2000-2011. Clonidine exposures were the most commonly reported, more symptomatic, and associated with 3 deaths. Despite central nervous system depression, bradycardia, and hypotension being common, the need for intubation and vasopressors was rare.
研究儿童意外暴露于 3 种常见的α-2 激动剂（可乐定、胍法辛和替扎尼定）的全国趋势。次要目标是描述结果、症状、治疗和死亡情况。
从 2000 年 1 月至 2011 年 12 月，对美国毒物控制中心国家毒物数据系统中年龄≤12 岁的儿童意外暴露于可乐定、胍法辛和替扎尼定的情况进行回顾性图表分析。
从 2000 年至 2011 年，儿童意外暴露于国家毒物数据系统的中枢α-2 激动剂的数量显著增加（每年增加 5.9%，95%置信区间：3.6%，8.2%）。可乐定暴露 27825 例（67.3%为男性，中位年龄：4 岁），胍法辛暴露 6143 例（69.8%为男性，中位年龄：6 岁），替扎尼定暴露 856 例（51.9%为男性，中位年龄：2 岁）。胍法辛是这三种药物中增加比例最大的。可乐定与最多的呼吸系统（799 例，2.9%）和中枢神经系统症状（12612 例，45.3%）以及最多的心动过缓（2847 例，10.2%）和低血压（2365 例，8.5%）有关。728 例（2.0%）患者需要插管，141 例（0.5%）患者需要使用血管加压素。可乐定导致 7 例心脏骤停和 3 例死亡。
2000 年至 2011 年，儿童意外暴露于α-2 激动剂的数量有所增加。可乐定暴露最为常见，症状更为明显，导致 3 例死亡。尽管常见中枢神经系统抑制、心动过缓和低血压，但需要插管和使用血管加压素的情况很少见。
