The toxidrome of which hypertensive medication can be confused with opioid overdose?

Clonidine is an alpha2 agonist that can cause mental status depression, hypoventilation, and miosis in overdose.  While hypertension and reflex bradycardia can occur secondary to initial alpha1 activation, most often patients present with hypotension and bradycardia from clonidine’s CNS effects.  Treatment is supportive.  Naloxone can be used but does not reverse all effects of the toxicity.  Other alpha2 agonists can present with similar toxicity (i.e. tetrahydrozyyline (eye drops) or xylazine (veterinary anesthetic)).

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