Trends and toxic effects from pediatric clonidine exposures
Trends and toxic effects from pediatric clonidine exposures
复制标题
DOI：
10.1001/archpedi.156.4.392
复制
发表时间：
2002-04-01
影响因子：
--
通讯作者：
Klein-Schwartz, W
中科院分区：
文献类型：
--
作者：
Klein-Schwartz, W
目的：为了分析趋势，人口统计学，和毒性作用与小儿盐酸可乐定暴露报告中毒centers.Design回顾性。设置和患者：可乐定只有暴露随访到已知的结果，在19岁以下的儿童报告中毒控制中心的数据库，从1993年1月1日至1999年12月31日。随着时间的推移，敏锐度，原因，症状，管理网站，治疗，和outcome.Results的曝光频率：有10 060报告的曝光与57%的儿童年龄小于6岁，34%的儿童之间的6和I岁，和9%的青少年之间的13和18岁。1999年的接触人数是1993年的2.5倍。在6至12岁的儿童中，可乐定是35%的儿童药物，而6岁以下儿童为10%，青少年为26%。7年来，涉及儿童用药的病例比例有所增加。虽然无意过量在6岁以下儿童中最常见，但治疗错误和自杀企图分别在6至12岁儿童和青少年中占主导地位。在6042名有症状的儿童（60%）中，最常见的症状是嗜睡（80%）、心动过缓（17%）、低血压（15%）和呼吸抑制（5%）。大多数暴露导致无影响（40%）或轻微影响（39%）。中度影响发生在1907名儿童（19%），主要影响230名儿童（2%），有我在23个月大的死亡率。结论：虽然大多数可乐定暴露导致最小的毒性作用，严重的毒性作用和死亡可能发生。儿童接触可乐定的人数有增加的趋势，特别是有证据表明接受可乐定治疗的儿童有毒性作用，这令人担忧。
Objective: To analyze the trends, demographics, and toxic effects associated with pediatric clonidine hydrochloride exposures reported to poison centers.Design: Retrospective.Setting and Patients: Clonidine-only exposures followed up to known outcome in children younger than 19 years reported to the American Association of Poison Control Center's database from January 1, 1993, through December 31, 1999.Main Outcome Measures: Frequency of exposures over time, acuity, reason, symptoms, management site, treatment, and outcome.Results: There were 10 060 reported exposures with 57% reported for children younger than 6 years, 34% for children between 6 and I years old, and 9% for adolescents between 13 and 18 years old. In 1999 there were 2.5 times as many exposures as in 1993. In 6- through 12-year-olds, clonidine was the child's medication in 35% of the exposures, compared with 10% in children younger than 6 years and 26% in adolescents. The proportion of cases involving the child's medication increased over 7 years. While unintentional overdose was most common in children younger than 6 years, therapeutic errors and suicide attempts predominated in 6- through 12-year-olds and adolescents, respectively. In 6042 symptomatic children (60%), the most common symptoms were lethargy (80%), bradycardia (17%), hypotension (15%), and respiratory depression (5%). Most exposures resulted in no effect (40%) or minor effects (39%). Moderate effects occurred in 1907 children (19%), major effects in 230 children (2%); there was I fatality in a 23-month-old.Conclusions: While most of the clonidine exposures resulted in minimal toxic effects, serious toxic effects and death can occur. The trend toward increasing the number of exposures in children, especially with evidence of toxic effects in children receiving clonidine therapeutically, is cause for concern.