Workup
Approach Considerations
Clonidine levels have not been shown to correlate with toxicity and should not be routinely drawn. Measure electrolyte and glucose levels to screen for anion gap acidosis or hypoglycemia.
Serum toxicology screen may be useful if the patient is not responding to standard measures; has significant symptoms and a co-ingestion is suspected; or is comatose. It may also be useful if a specific drug level is desired. Acetaminophen levels should be obtained if overdose is suspected.
Other studies to consider include the following:
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Test for pregnancy in women of childbearing age.
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Perform a 12-lead electrocardiogram (ECG) in addition to continuous cardiac monitoring.
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Obtain a noncontrast cranial computed tomography (CT) scan if hemorrhagic bleeding, stroke, or head trauma is suspected.
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Consider an emergent magnetic resonance imaging (MRI) scan if concern exists over a brainstem infarct or a change in management may result.
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Lumbar puncture may be indicated in patients with altered mental status and suspicion of CNS infection.
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