Sir.—Clonidine hydrochloride is one of several medications that can produce serious toxicity in children with ingestion of only a small amount. We describe a 3-year-old child who ingested a single 0.2-mg clonidine hydrochloride tablet and developed coma, respiratory depression, and hypotension. This is the lowest dose reported to cause such profound toxicity in a young child.
Patient Report.—A 3-year-old boy ingested one of his grandmother's 0.2-mg clonidine hydrochloride (Catapres) tablets. Actual ingestion was not observed, but a single tablet placed on a table was missing. The child indicated he had eaten it. He was transported by ambulance to the local emergency department.
Approximately 1 hour after ingestion, the child was very lethargic and pale. His vital signs were as follows: heart rate, 76 beats per minute; respiratory rate, 8 to 10 per minute; and blood pressure, 100/80mm Hg. An intravenous line was placed and 5% dextrose in lactated