Title: Xenobiotics That Cause Unusual or Idiosyncratic Reactions in Children

Category: Toxicology

Keywords: benzyl alcohol, clonidine, ethanol, chloramphenicol (PubMed Search)

Posted: 3/10/2011 by Bryan Hayes, PharmD (Updated: 3/10/2011)

Several medications/chemicals can cause unique toxicologic reactions in pediatric patients.

Ethanol: hypoglycemia. Reported with ethanol levels as low as 20 mg/dL.
Clonidine and imidazolines: central nervous system effects. Agents such as tetrahydrozoline, oxymetazoline, naphazoline, and clonidine can cause CNS depression, respiratory depression, bradycardia, miosis, and hypotension.
Benzyl alcohol: gasping syndrome. Preservative which has been removed from most medications and IV flush solutions used in neonates. Syndrome includes severe metabolic acidosis, encephalopathy, respiratory depression, and gasping.
Chloramphenicol: gray baby syndrome. Broad-spectrum antibiotic not used frequently in U.S. Syndrome includes abdominal distension, vomiting, metabolic acidosis, progressive pallid cyanosis, irregular respirations, hypothermia, hypotension, and vasomotor collapse.