Gössinger H, Hruby K, Haubenstock A, Jung M, Pfister R
Wien Klin Wochenschr. 1983 Apr 1;95(7):232-5.
In this study clinical findings are presented of 31 patients with clonidinee intoxication and the therapeutic measures taken in these cases are discussed. In toddlers poisoning is seen after ingestion of a single tablet of 150 micrograms clonidine, whilst in adults poisoning may occur already at a dosage just exceeding the therapeutic limit, which is subject to wide individual variation (1 to 3 tablets). Primary elimination procedures must be instituted at these dosages, but, because of the rapid absorption of clonidine, gastric lavage and induced emesis provide no benefit to patients with complete symptomatology or those who took the overdose several hours before. Chlorpromazine-like effects, hypotension and bradycardia proved to be the outstanding features. Respiratory depression, disturbances of myocardial conduction or hypertension were less frequent. Symptoms lasted for a mean of 15.5 +/- 8.6 hours, with a range of 4 to 36 hours. Fluid therapy and, as necessary, dopamine for hypotension, phentolamine for hypertension and atropine for bradycardia caused prompt improvement in addition to essential measures such as meticulous control of respiratory function, body temperature and of ECG changes. There was no need to implement the central clonidine antagonist, tolazoline in any of these cases.
本研究报告了31例可乐定中毒患者的临床症状,并讨论了针对这些病例采取的治疗措施。在幼儿中,摄入一片150微克的可乐定即可导致中毒,而在成人中,中毒可能在剂量刚超过治疗限度时就会发生,该限度存在很大的个体差异(1至3片)。在这些剂量下必须采取初步清除程序,但是,由于可乐定吸收迅速,洗胃和催吐对症状已完全显现的患者或在数小时前服用过量药物的患者并无益处。氯丙嗪样效应、低血压和心动过缓被证明是突出特征。呼吸抑制、心肌传导障碍或高血压则较少见。症状平均持续15.5±8.6小时,范围为4至36小时。除了精心控制呼吸功能、体温和心电图变化等基本措施外,液体疗法以及必要时使用多巴胺治疗低血压、酚妥拉明治疗高血压和阿托品治疗心动过缓,均能使症状迅速改善。在所有这些病例中均无需使用中枢性可乐定拮抗剂妥拉唑啉。