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Naloxone in Clonidine Toxicity-Reply

Am J Dis Child. 1984;138(11):1084-1085. doi:10.1001/archpedi.1984.02140490084024.
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In Reply.—While it is tempting to keep score on patients who have and have not responded to naloxone hydrochloride therapy for clonidine hydrochloride intoxication, certain criteria should be met before we can begin to accept anecdotal data on the efficacy of this therapy. A positive response to naloxone should only be described in the absence of any noxious stimuli, particularly avoiding intramuscular injections or extravasation of intravenous solutions. In addition, the reversal of coma should be consistent with the pharmacokinetics of naloxone and provide a continuing benefit over a one- to four-hour period in a dose-dependent fashion.1 As can be seen in our original article,2 one patient whose condition was continuously monitored had an episode of raised level of consciousness and increased heart rate and respiratory rate not associated with administration of any medication. Thus, it is important to look beyond simply a change in consciousness and


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