433 results match your criteria Toxicity Clonidine

To Compare the Efficacy of Postoperative Analgesia between Clonidine and Dexmedetomidine as Adjuvants with 0.5% Ropivacaine by Ultrasound-Guided Supraclavicular Brachial Plexus Block for Upper Limb Surgeries: A Prospective, Double-Blind, Randomized Study.

Anesth Essays Res 2020 Oct-Dec;14(4):644-652. Epub 2021 May 27.

Department of General Surgery, ESI Medical College, Patna, Bihar, India.

Context: The supraclavicular brachial plexus block is a very safe, useful and effective method for upper limb surgeries. Among local anesthetics, ropivacaine has special applications in neuraxial and peripheral nerve blocks due to its low cardiotoxicity and less toxicity to central nervous systems compared to bupivacaine and lignocaine. Dexmedetomidine is a newer and potent alpha-2 receptor agonist which has 10 times higher selectivity for alpha-2 receptors as compared to clonidine, So far, very few studies have been undertaken to compare the efficacy of clonidine and dexmedetomidine to provide and prolong postoperative analgesia, especially with the use of ultrasound for nerve localization. Read More

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Methadone, Buprenorphine, and Clonidine Attenuate Mitragynine Withdrawal in Rats.

Front Pharmacol 2021 12;12:708019. Epub 2021 Jul 12.

Centre for Drug Research, Universiti Sains Malaysia, Minden, Malaysia.

Kratom or Korth has been widely used to relieve the severity of opioid withdrawal in natural settings. However, several studies have reported that kratom may by itself cause dependence following chronic consumption. Yet, there is currently no formal treatment for kratom dependence. Read More

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Serotonin Toxicity Versus Withdrawal: Clonidine One Size Fits All?

J Pediatr Pharmacol Ther 2021 28;26(5):502-517. Epub 2021 Jun 28.

Serotonin discontinuation syndrome (SDS) can result in a constellation of symptoms exhibited by infants exposed to selective serotonin reuptake inhibitors or other psychotropic drugs during pregnancy. Currently, there is no consensus regarding the pharmacologic management of SDS. We report our experience with clonidine for the management of a term infant with poor neonatal adaption. Read More

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Alpha 1-adrenoceptor signalling contributes to toxic effects of catecholamine on electrical properties in cardiomyocytes.

Europace 2021 07;23(7):1137-1148

First Department of Medicine, University Medical Centre Mannheim (UMM), University of Heidelberg, Mannheim, Germany.

Aims: This study aimed to investigate possible roles and underlying mechanisms of alpha-adrenoceptor coupled signalling for the pathogenesis of Takotsubo syndrome (TTS).

Methods And Results: Human-induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) were treated with a toxic concentration of epinephrine (Epi, 0.5 mM for 1 h) to mimic the setting of TTS. Read More

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Efficacy of Periarticular Cocktail Injection in Rheumatoid Patients Undergoing Total Knee Replacement.

Indian J Orthop 2020 Nov 20;54(6):811-822. Epub 2020 Aug 20.

Department of Orthopaedic Surgery, Sree Sudheendra Medical Mission Hospital, Chittoor Road, Cochin, Kerala India.

Background: Pain control after total knee replacement (TKR) is of primary importance to joint replacement surgeons to achieve good functional outcome post-surgery. This becomes even more challenging when these major procedures are done in immunocompromised patients like rheumatoid arthritis. Good peri-operative analgesia facilitates early rehabilitation, improves patient satisfaction, and reduces the hospital stay. Read More

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November 2020

Adrenergic Modulation With Photochromic Ligands.

Angew Chem Int Ed Engl 2021 02 21;60(7):3625-3631. Epub 2020 Dec 21.

Institute for Bioengineering of Catalonia (IBEC), The Barcelona Institute for Science and Technology (BIST), Barcelona, Spain.

Adrenoceptors are ubiquitous and mediate important autonomic functions as well as modulating arousal, cognition, and pain on a central level. Understanding these physiological processes and their underlying neural circuits requires manipulating adrenergic neurotransmission with high spatio-temporal precision. Here we present a first generation of photochromic ligands (adrenoswitches) obtained via azologization of a class of cyclic amidines related to the known ligand clonidine. Read More

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February 2021

Chemical composition of Zhumeria majdae essential oil and its effects on the expression of morphine withdrawal syndrome and tolerance to the anticonvulsant effect of morphine on pentylenetetrazole-induced seizures in mice.

Braz J Biol 2021 Oct-Dec;81(4):881-886. Epub 2021 Nov 30.

Department of Pharmacognosy, Faculty of Pharmacy and Pharmaceutical Sciences, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran.

Regarding the proven anticonvulsant effect of Zhumeria majdae essential oil (ZMEO) in previous studies we were prompted to investigate the ZMEO effects on the tolerance to the anticonvulsant effects of morphine and the morphine withdrawal syndrome. Tolerance to the morphine anticonvulsant effect was induced in mice by subcutaneous injection of 2.5 mg/kg of morphine for 4 days. Read More

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February 2021

Xylazine, a Veterinary Tranquilizer, Detected in 42 Accidental Fentanyl Intoxication Deaths.

Am J Forensic Med Pathol 2021 Mar;42(1):9-11

From the Office of the Chief Medical Examiner, Farmington, CT.

Abstract: Xylazine is an emerging adulterant with fentanyl in fatal drug intoxications, which has public health, safety, and criminal investigative implications. Xylazine is a nonnarcotic sedative used for analgesia and muscle relaxation exclusively in veterinary medicine. Its chemical structure is similar to clonidine and acts as a central α-2 agonist which may cause bradycardia and transient hypertension followed by hypotension. Read More

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"Road Rash" and Dizziness: A Case of Hemodynamically Significant Topical Clonidine Toxicity.

Mil Med 2021 02;186(3-4):e451-e453

Division of Clinical Toxicology, Department of Emergency Medicine, Virginia Commonwealth University Health Sys tem, Richmond, VA, 23219, USA.

Clonidine is a central alpha-2 agonist well known to produce a syndrome of bradycardia and hypotension in overdose. However, few examples of overt clinical clonidine toxicity secondary to cutaneous absorption have been reported. We report a case of unintentional systemic clonidine toxicity in an adult because of a compounded preparation of clonidine applied to a degraded skin barrier. Read More

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February 2021

Transmuscular quadratus lumborum (TQL) block for laparoscopic colorectal surgery: study protocol for a double-blind, prospective randomized placebo-controlled trial.

Trials 2020 Jun 26;21(1):581. Epub 2020 Jun 26.

Department of Anaesthesiology, University Hospitals of the KU Leuven, Herestraat 49, B-3000, Leuven, Belgium.

Background: Thoracic epidural anesthesia is no longer considered the gold standard for perioperative analgesia in laparoscopic colorectal procedures. In the search for alternatives, the efficacy of the transverse abdominal plane (TAP) block and other abdominal wall blocks such as the transmuscular quadratus lumborum (TQL) block continues to be investigated for postoperative pain management. Most of the initial studies on TAP blocks reported positive effects; however, the amount of studies with negative outcomes is increasing, most probably due to the fact that the majority of abdominal wall blocks fail to mitigate visceral pain. Read More

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Clonidine Compounding Error: Bradycardia and Sedation in a Pediatric Patient.

J Emerg Med 2020 Jul 7;59(1):53-55. Epub 2020 May 7.

Harvard Medical Toxicology Fellowship, Boston Children's Hospital, Boston, Massachusetts; Division of Emergency Medicine, Boston Children's Hospital, Boston, Massachusetts.

Background: Clonidine is a centrally-acting α-2 agonist used in the treatment of hypertension and attention-deficit/hyperactivity disorder, among other off-label uses. In overdose, it can cause sedation, bradycardia, and hypotension. Clonidine can be compounded as a liquid formula for patients who are unable to take pills, however, this can add to the risk of dosing errors. Read More

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A review of neuropsychiatric adverse events from topical ophthalmic brimonidine.

N Cimolai

Hum Exp Toxicol 2020 Oct 29;39(10):1279-1290. Epub 2020 Apr 29.

Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada.

Brimonidine is a first-line topical medication for increased intraocular pressure and glaucoma which may be used alone or in conjunction with other topical therapies. Its structural and pharmacological comparabilities to clonidine give way to the hypothesis that it may cause neuropsychiatric side effects. The majority of case reports citing brimonidine toxicity, either for topical or peripheral exposure, include pediatric age groups but especially infants. Read More

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October 2020

Pharmacodynamics of intrathecal and epidural fadolmidine, an α-adrenoceptor agonist, after bolus and infusion in dogs-comparison with clonidine.

Naunyn Schmiedebergs Arch Pharmacol 2020 08 16;393(8):1459-1473. Epub 2020 Mar 16.

Research and Development, Orion Corporation Orion Pharma, P.O.Box 425, 20101, Turku, Finland.

An α-adrenoceptor agonist, clonidine, is extensively used in both anesthesia and intensive care medicine. However, clonidine may produce pronounced hemodynamic side effects such as hypotension and bradycardia which may limit its usefulness in certain conditions. Fadolmidine is a potent α-adrenoceptor agonist with different physicochemical properties than clonidine. Read More

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Studies on retinal mechanisms possibly related to myopia inhibition by atropine in the chicken.

Graefes Arch Clin Exp Ophthalmol 2020 Feb 26;258(2):319-333. Epub 2019 Dec 26.

Section of Neurobiology of the Eye, Ophthalmic Research Institute, University of Tuebingen, Tuebingen, Germany.

Purpose: While low-dose atropine eye drops are currently widely used to inhibit myopia development in children, the underlying mechanisms are poorly understood. Therefore, we studied possible retinal mechanisms and receptors that are potentially involved in myopia inhibition by atropine.

Methods: A total of 250 μg atropine were intravitreally injected into one eye of 19 chickens, while the fellow eyes received saline and served as controls. Read More

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February 2020

Safety and Efficacy of an On-Site Intensive Treatment Protocol for Mild and Moderate Sympathomimetic Toxicity at Australian Music Festivals.

Prehosp Disaster Med 2020 Feb 6;35(1):41-45. Epub 2019 Dec 6.

Edith Cowan University, School of Medical and Health Sciences, Joondalup, Western Australia, Australia.

Introduction: Serotonin and sympathomimetic toxicity (SST) after ingestion of amphetamine-based drugs can lead to severe morbidity and death. There have been evaluations of the safety and efficacy of on-site treatment protocols for SST at music festivals.

Problem: The study aimed to examine the safety and efficacy of treating patients with SST on-site at a music festival using a protocol adapted from hospital-based treatment of SST. Read More

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February 2020

Alpha-adrenergic dysregulation in congenic DxH recombinant inbred mice selectively bred for a high fear-sensitized (H-FSS) startle response.

Pharmacol Biochem Behav 2020 01 2;188:172835. Epub 2019 Dec 2.

Department of Biomedical Sciences, School of Medicine, Creighton University, Omaha, NE, USA; Institute of Anatomy, Medical Faculty, University of Magdeburg, Germany; Clinical Neuroanatomy Section, Neurology Department, School of Medicine, Ulm University, Germany. Electronic address:

Patients with anxiety disorders and posttraumatic stress disorder (PTSD) exhibit exaggerated fear responses and noradrenergic dysregulation. Fear-related responses to α-adrenergic challenge were therefore studied in DxH C3H/HeJ-like recombinant inbred (C3HLRI) mice, which are a DBA/2J-congenic strain selectively bred for a high fear-sensitized startle (H-FSS). C3HLRI mice showed an enhanced acoustic startle response and immobility in the forced swim test compared to DBA/2J controls. Read More

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January 2020

Pharmacology of Common Analgesic and Sedative Drugs Used in the Neonatal Intensive Care Unit.

Clin Perinatol 2019 12 14;46(4):673-692. Epub 2019 Aug 14.

Department of Pediatrics, Division of Neonatology, UMKC School of Medicine, Children's Mercy Hospital, 2401 Gillham Road, Kansas City, MO 64108, USA; Division of Clinical Pharmacology, Toxicology and Therapeutic Innovation, Department of Pediatrics, Division of Pediatric Clinical Pharmacology, UMKC School of Medicine, Children's Mercy Hospital, Kansas City, MO, USA. Electronic address:

In this review of analgesic and sedation medication in neonates, important classes of old and newer medications commonly used in the neonatal intensive care unit setting are discussed. In addition to drug metabolism, efficacy, and safety for individual drugs, new insights into multimodal analgesic approaches suggest ways in which multiple analgesic drug classes can be combined to maximize efficacy and minimize toxicity. Opiate pharmacogenetics and the potential for a precision therapeutics approach is explored, with a final description of gaps in knowledge and a call for future research of pain and sedation control in the neonatal population. Read More

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December 2019

Effects of 24 CYP2D6 variants found in Chinese population on the metabolism of clonidine in vitro.

Chem Biol Interact 2019 Nov 1;313:108840. Epub 2019 Oct 1.

Department of Pharmacology, School of Pharmacy of Wenzhou Medical University, Wenzhou, Zhejiang, China. Electronic address:

Background And Objectives: Clonidine has been clinically used to treat Tourette's syndrome for decades. There was research finding that clonidine possessed the best risk-benefit ratio, especially for patients associated with attention deficit hyperactivity disorder. CYP2D6 is a significant member of Cytochrome P450 enzymes. Read More

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November 2019

Clinically Relevant Drug-Drug Interactions in Primary Care.

Am Fam Physician 2019 05;99(9):558-564

Medical College of Georgia at Augusta University, Augusta, GA, USA.

Drug interactions are common in the primary care setting and are usually predictable. Identifying the most important and clinically relevant drug interactions in primary care is essential to patient safety. Strategies for reducing the risk of drug-drug interactions include minimizing the number of drugs prescribed, re-evaluating therapy on a regular basis, considering nonpharmacologic options, monitoring for signs and symptoms of toxicity or effectiveness, adjusting dosages of medications when indicated, and adjusting administration times. Read More

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Amphetamine and Clonidine Toxicity Resulting in Posterior Reversible Encephalopathy Syndrome.

Pediatr Emerg Care 2021 Dec;37(12):e1721-e1723

Emergency Medicine.

Abstract: Amphetamine toxicity typically presents with hypertension and tachycardia. Conversely, clonidine acts as an agonist at central α2 and imidazoline receptors, which may cause brief initial hypertension followed by hypotension and bradycardia in overdose. We report a case of mixed ingestion resulting in posterior reversible encephalopathy syndrome (PRES) successfully treated with phentolamine. Read More

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December 2021

Caudal epidural blocks in paediatric patients: a review and practical considerations.

Br J Anaesth 2019 Apr 1;122(4):509-517. Epub 2019 Feb 1.

Department of Paediatric Anesthesia and Intensive Care, Section of Anaesthesiology and Intensive Care, Karolinska University Hospital, Stockholm, Sweden; Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.

Caudal epidural blockade in children is one of the most widely administered techniques of regional anaesthesia. Recent clinical studies have answered major pharmacodynamic and pharmacokinetic questions, thus providing the scientific background for safe and effective blocks in daily clinical practice and demonstrating that patient selection can be expanded to range from extreme preterm births up to 50 kg of body weight. This narrative review discusses the main findings in the current literature with regard to patient selection (sub-umbilical vs mid-abdominal indications, contraindications, low-risk patients with spinal anomalies); anatomical considerations (access problems, age and body positioning, palpation for needle insertion); technical considerations (verification of needle position by ultrasound vs landmarks vs 'whoosh' or 'swoosh' testing); training and equipment requirements (learning curve, needle types, risk of tissue spreading); complications and safety (paediatric regional anaesthesia, caudal blocks); local anaesthetics (bupivacaine vs ropivacaine, risk of toxicity in children, management of toxic events); adjuvant drugs (clonidine, dexmedetomidine, opioids, ketamine); volume dosing (dermatomal reach, cranial rebound); caudally accessed lumbar or thoracic anaesthesia (contamination risk, verifying catheter placement); and postoperative pain. Read More

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Evaluation of Antidepressant Effects on Recovery of Electrical Field Stimulation-Induced Contractions that have been Suppressed by Clonidine in Isolated Rat Vas Deferens.

Pharmacology 2019 29;103(3-4):189-201. Epub 2019 Jan 29.

Department of Chemical Pharmacology, Faculty of Pharmaceutical Sciences, Toho University, Funabashi, Japan,

Background: A report examining whether clinically available antidepressants increase urethral smooth muscle contraction via antagonistic effects on the α2-adrenoceptor (α2-AR) is lacking.

Objectives: The present study was performed to evaluate the potential of clinically available antidepressants to reverse α2-AR-mediated contractile inhibition in rat vas deferens, in order to predict whether they can induce voiding impairment.

Method: The effects of 18 antidepressants of different classes on electrical field stimulation (EFS)-induced contractions suppressed by 10-8 mol/L clonidine (a selective α2-AR agonist) in isolated rat vas deferens were investigated and related to their respective clinical blood concentrations. Read More

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High-Throughput Video Processing of Heart Rate Responses in Multiple Wild-type Embryonic Zebrafish per Imaging Field.

Sci Rep 2019 01 15;9(1):145. Epub 2019 Jan 15.

National Health and Environmental Effects Research Laboratory, US Environmental Protection Agency, Research Triangle Park, NC, USA.

Heart rate assays in wild-type zebrafish embryos have been limited to analysis of one embryo per video/imaging field. Here we present for the first time a platform for high-throughput derivation of heart rate from multiple zebrafish (Danio rerio) embryos per imaging field, which is capable of quickly processing thousands of videos and ideal for multi-well platforms with multiple fish/well. This approach relies on use of 2-day post fertilization wild-type embryos, and uses only bright-field imaging, circumventing requirement for anesthesia or restraint, costly software/hardware, or fluorescently-labeled animals. Read More

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January 2019

Cross-sectional survey of off-label and unlicensed prescribing for inpatients at a paediatric teaching hospital in Western Australia.

PLoS One 2019 8;14(1):e0210237. Epub 2019 Jan 8.

School of Pharmacy and Biomedical Sciences, Curtin University, Perth, Western Australia, Australia.

Objectives: To evaluate the prevalence of off-label and unlicensed prescribing in inpatients at a major paediatric teaching hospital in Western Australia and to identify which drugs are commonly prescribed off-label or unlicensed, including factors influencing such prescribing.

Methods: A retrospective cross-sectional study was conducted in June, 2013. Patient and prescribing data were collected from 190 inpatient medication chart records which had been randomly selected from all admissions during the second week of February 2013. Read More

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October 2019

Antiasthmatic potential of Zizyphus jujuba Mill and Jujuboside B. - Possible role in the treatment of asthma.

Respir Physiol Neurobiol 2019 02 3;260:28-36. Epub 2018 Dec 3.

R.C. Patel Institute of Pharmaceutical Education & Research, Shirpur, Dhule, 425405, India.

Zizyphus jujuba Mill, a famous oriental traditional medicine, has been reported to exhibit diverse activities in biological systems including the respiratory system. However, a little information is available on its antiasthmatic activity. Jujuboside B (JB) is a natural saponin and one of the active constituent of fruits of Zizyphus jujuba. Read More

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February 2019

Clonidine exposures in children under 6 (2004-2017): a retrospective study.

Arch Dis Child 2019 03 13;104(3):287-291. Epub 2018 Nov 13.

New South Wales Poisons Information Centre, The Children's Hospital at Westmead, Westmead, New South Wales, Australia.

Objective: To describe trends in clonidine exposures in children under 6. Clonidine has become increasingly popular for management of paediatric behavioural disorders. Clonidine has a narrow therapeutic index, and toxicity can occur with inadvertent double dosing. Read More

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Pharmacologic Treatment of Opioid Use Disorder: a Review of Pharmacotherapy, Adjuncts, and Toxicity.

J Med Toxicol 2018 12 30;14(4):306-322. Epub 2018 Oct 30.

Harvard Medical Toxicology Program, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA.

Opioid use disorder continues to be a significant source of morbidity and mortality in the USA and the world. Pharmacologic treatment with methadone and buprenorphine has been shown to be effective at retaining people in treatment programs, decreasing illicit opioid use, decreasing rates of hepatitis B, and reducing all cause and overdose mortality. Unfortunately, barriers exist in accessing these lifesaving medications: users wishing to start buprenorphine therapy require a waivered provider to prescribe the medication, while some states have no methadone clinics. Read More

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December 2018

Clonidine Protects Against Neurotoxicity Induced by Sevoflurane Through NF-κB Signaling Inhibition and Proinflammatory Cytokine Release in Rats.

J Mol Neurosci 2018 Aug 2;65(4):507-513. Epub 2018 Aug 2.

Department of Anesthesia, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.

Exposure of neonatal animals to anesthetics may cause developmental functional changes and acute structural anomalies in the brain. Clonidine, an α2-adrenoceptor agonist, functions as an analgesic and sedative and protects against brain injury. Nevertheless, whether clonidine protects the developing brain from damage caused by sevoflurane (SEVO) anesthesia remains unclear. Read More

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Pharmacopuncture With Scolopendra subspinipes Suppresses Mechanical Allodynia in Oxaliplatin-Induced Neuropathic Mice and Potentiates Clonidine-induced Anti-allodynia Without Hypotension or Motor Impairment.

J Pain 2018 10 4;19(10):1157-1168. Epub 2018 Jun 4.

Dental Research Institute and Department of Neurobiology and Physiology School of Dentistry; Department of Brain and Cognitive Sciences College of Natural Sciences, Seoul National University, Seoul, Republic of Korea. Electronic address:

Chemotherapy-induced neuropathic pain is a common dose-limiting side effect of anticancerdrugs but lacks an effective treatment strategy. Scolopendra subspinipes has been used in traditional medicine to treat chronic neuronal diseases. Moreover, pharmacopuncture with S subspinipes (SSP) produces potent analgesia in humans and experimental animals. Read More

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October 2018