Kappagoda C, Schell D N, Hanson R M, Hutchins P
Royal Alexandra Hospital for Children, Parramatta, New South Wales, Australia.
J Paediatr Child Health. 1998 Dec;34(6):508-12. doi: 10.1046/j.1440-1754.1998.00301.x.
To highlight the increase in the number of cases of clonidine overdose admitted to a specialist paediatric hospital, with particular reference to the clinical features, clinical course and circumstances surrounding the incident.
Cases of clonidine overdose were identified by review of the emergency department attendance register, the intensive care unit database and inpatient statistics collection. Case notes were reviewed to determine the clinical features, history and clinical course in each case.
Fifteen patients experienced 16 overdoses during the period 1990-97 inclusive. Only one case occurred before 1994. Depressed level of consciousness and bradycardia were the most common clinical manifestations, and were observed in 75 and 88% of cases respectively. There were no fatalities. Five patients received naloxone. Other treatment modalities included gastrointestinal decontamination, atropine, ventilation and inotropic support. Fourteen cases occurred in association with medication prescribed for attention-deficit hyperactivity disorder (ADHD).
Clonidine overdose is a potentially serious condition, often requiring intensive care management. Our experience suggests that it is a growing problem, related in part to its increased use in the treatment of ADHD. Preventive strategies, including raising the level of awareness of risks, changes to packaging and appropriate selection of patients for treatment, need consideration if further overdoses are to be prevented.
强调一家专业儿科医院收治的可乐定过量病例数量的增加，特别提及事件的临床特征、临床病程及相关情况。
通过查阅急诊科就诊登记册、重症监护病房数据库和住院患者统计数据来确定可乐定过量病例。查阅病例记录以确定每个病例的临床特征、病史和临床病程。
在1990年至1997年（含）期间，15名患者发生了16次过量用药情况。仅1例发生在1994年之前。意识水平降低和心动过缓是最常见的临床表现，分别在75%和88%的病例中出现。无死亡病例。5名患者接受了纳洛酮治疗。其他治疗方式包括胃肠道去污、阿托品、通气和强心支持。14例与为注意力缺陷多动障碍（ADHD）开具的药物有关。
可乐定过量是一种潜在的严重情况，通常需要重症监护管理。我们的经验表明这是一个日益严重的问题，部分原因是其在ADHD治疗中的使用增加。如果要预防进一步的过量用药情况，需要考虑预防策略，包括提高风险意识、改变包装以及为治疗适当选择患者。
