Clonidine is a central acting alpha-2 receptor agonist taken to lower blood pressure and decrease central alpha agonism in ADHD and opiate withdrawal. It can present similar to opiate overdose with miosis, hypotension, bradycardia, respiratory depression and somnolence. Treatment is often supportive with the infant or young child admitted for observation. As seen in the illustration, the child will respond to physical stimulation and can usually be quickly aroused. Naloxone can have some benefit, but usually requires larger doses than seen in opiate overdose. The use of naloxone can have some benefit if opiate overdose is suspected.
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