{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T22:09:05Z","timestamp":1763762945932,"version":"3.45.0"},"reference-count":13,"publisher":"The Pediatric Pharmacy Association","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10]]},"abstract":"\n OBJECTIVE<\/jats:title>\n This study aimed to evaluate the success and safety of an institution-specific strategy for converting dexmedetomidine to clonidine in the cardiac intensive care unit at a tertiary care pediatric hospital.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n This retrospective descriptive study included pediatric patients under 18 years of age receiving at least 7 days of dexmedetomidine infusion before conversion to clonidine between January 1, 2018, and October 1, 2023. A successful conversion was defined as dexmedetomidine infusion discontinuation in the absence of therapy reinitiation within 36 hours after the initial enteral clonidine dose; no dose increases greater than 15% within 36 hours of initial clonidine dose, and no requirement for supplemental doses. Patients with dexmedetomidine discontinuation before completing stepwise conversion were evaluated for adverse drug events (ADEs). Descriptive statistics were used to analyze the data.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n A total of 148 episodes of conversion from dexmedetomidine to clonidine were evaluated for 134 patients. Patient demographics and treatment characteristics included a median age at conversion of 4.6 months (IQR, 1.5\u20137.1), a median duration of dexmedetomidine exposure of 19 days (IQR, 12\u201334), a median initial clonidine dose of 9.3 mcg\/kg\/day (IQR, 7.2\u201310), and a median time to discontinuation of 19 hours (IQR, 17\u201336) after the first dose of clonidine. Successful conversion occurred in 99 (67%) of episodes evaluated, and no ADEs were identified.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSION<\/jats:title>\n The conversion allowed for most patients to tolerate the conversion to clonidine, and no ADEs were identified.<\/jats:p>\n <\/jats:sec>","DOI":"10.5863\/jppt-24-00084","type":"journal-article","created":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T22:04:07Z","timestamp":1763762647000},"page":"623-629","source":"Crossref","is-referenced-by-count":0,"title":["Evaluation of Institution-Specific Strategy for Converting Dexmedetomidine to Clonidine in a Pediatric Cardiac Intensive Care Unit"],"prefix":"10.5863","volume":"30","author":[{"given":"Christopher","family":"Phillips","sequence":"first","affiliation":[{"name":"Department of Pharmacy Services (CP, AS, EZR), Quality and Safety Services (HC), and Anesthesiology and Critical Care Medicine (EH), Children\u2019s Hospital of Philadelphia, Philadelphia, PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Sweigart","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Services (CP, AS, EZR), Quality and Safety Services (HC), and Anesthesiology and Critical Care Medicine (EH), Children\u2019s Hospital of Philadelphia, Philadelphia, PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hailey","family":"Collier","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Services (CP, AS, EZR), Quality and Safety Services (HC), and Anesthesiology and Critical Care Medicine (EH), Children\u2019s Hospital of Philadelphia, Philadelphia, PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Herrup","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Services (CP, AS, EZR), Quality and Safety Services (HC), and Anesthesiology and Critical Care Medicine (EH), Children\u2019s Hospital of Philadelphia, Philadelphia, PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Evan Zachary","family":"Ramsey","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Services (CP, AS, EZR), Quality and Safety Services (HC), and Anesthesiology and Critical Care Medicine (EH), Children\u2019s Hospital of Philadelphia, Philadelphia, PA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3883","reference":[{"issue":"1","key":"i2331-348X-30-5-623-b01","series-title":"Proc (Bayl Univ Med Cent)","first-page":"13","article-title":"Dexmedetomidine: a novel sedative-analgesic agent","volume":"14","author":"Gertler","year":"2001","unstructured":"Gertler R, Brown HC, Mitchell DH, Silvius EN. Dexmedetomidine: a novel sedative-analgesic agent. Proc (Bayl Univ Med Cent). 2001;14(1):13\u201321."},{"key":"i2331-348X-30-5-623-b02","year":"2022","unstructured":"Precedex [package insert]. Lake Forest, IL: Hospira, Inc; 2022."},{"issue":"1","key":"i2331-348X-30-5-623-b03","series-title":"J Pediatr Pharmacol Ther","first-page":"16","article-title":"Survey of the current use of dexmedetomidine and management of withdrawal symptoms in critically ill children","volume":"24","author":"Thompson","year":"2019","unstructured":"Thompson RZ, Gardner BM, Autry EB, et al. Survey of the current use of dexmedetomidine and management of withdrawal symptoms in critically ill children. J Pediatr Pharmacol Ther. 2019;24(1):16\u201321."},{"issue":"2","key":"i2331-348X-30-5-623-b04","series-title":"Pediatr Crit Care Med","first-page":"e74","article-title":"Society of Critical Care Medicine Clinical Practice Guidelines on prevention and management of pain, agitation, neuromuscular blockade, and delirium in critically ill pediatric patients with consideration of the ICU environment and early mobility","volume":"23","author":"Smith","year":"2022","unstructured":"Smith HAB, Besunder JB, Betters KA, et al. 2022 Society of Critical Care Medicine Clinical Practice Guidelines on prevention and management of pain, agitation, neuromuscular blockade, and delirium in critically ill pediatric patients with consideration of the ICU environment and early mobility. Pediatr Crit Care Med. 2022;23(2):e74\u2013e110."},{"issue":"6","key":"i2331-348X-30-5-623-b05","series-title":"J Pediatr Pharmacol Ther","first-page":"453","article-title":"Prolonged dexmedetomidine infusion and drug withdrawal in critically ill children","volume":"22","author":"Haenecour","year":"2017","unstructured":"Haenecour AS, Seto W, Urbain CM, et al. Prolonged dexmedetomidine infusion and drug withdrawal in critically ill children. J Pediatr Pharmacol Ther. 2017;22(6):453\u2013460."},{"issue":"4","key":"i2331-348X-30-5-623-b06","series-title":"J Pediatr Pharmacol Ther","first-page":"278","article-title":"The impact of a clonidine transition protocol on dexmedetomidine withdrawal in critically ill pediatric patients","volume":"25","author":"Liu","year":"2020","unstructured":"Liu J, Miller J, Ferguson M, et al. The impact of a clonidine transition protocol on dexmedetomidine withdrawal in critically ill pediatric patients. J Pediatr Pharmacol Ther. 2020;25(4):278\u2013287."},{"issue":"2","key":"i2331-348X-30-5-623-b07","series-title":"J Pediatr Pharmacol Ther","first-page":"104","article-title":"Evaluating the transition from dexmedetomidine to clonidine for the prevention of withdrawal in critically ill pediatric patients","volume":"25","author":"Lee","year":"2020","unstructured":"Lee MM, Caylor K, Gockenbach N. Evaluating the transition from dexmedetomidine to clonidine for the prevention of withdrawal in critically ill pediatric patients. J Pediatr Pharmacol Ther. 2020;25(2):104\u2013110."},{"issue":"04","key":"i2331-348X-30-5-623-b08","series-title":"J Pediatr Intensive Care","first-page":"327","article-title":"Evaluation of an enteral clonidine taper following prolonged dexmedetomidine exposure in critically ill children","volume":"11","author":"Crabtree","year":"2021","unstructured":"Crabtree MF, Sargel CL, Cloyd CP, Tobias JD, Abdel-Rasoul M, Thompson RZ. Evaluation of an enteral clonidine taper following prolonged dexmedetomidine exposure in critically ill children. J Pediatr Intensive Care. 2021;11(04):327\u2013334."},{"issue":"6","key":"i2331-348X-30-5-623-b09","series-title":"J Pediatr Pharmacol Ther","first-page":"542","article-title":"Clonidine for dexmedetomidine withdrawal in pediatric patients: a single center\u2019s experience","volume":"24","author":"Beitz","year":"2019","unstructured":"Beitz ER, Seabury R, Miller CD, Darko WQ, Probst LA, Steidl KE. Clonidine for dexmedetomidine withdrawal in pediatric patients: a single center\u2019s experience. J Pediatr Pharmacol Ther. 2019;24(6):542\u2013543."},{"issue":"1","key":"i2331-348X-30-5-623-b10","series-title":"J Pediatr Pharmacol Ther","first-page":"17","article-title":"Dexmedetomidine use in pediatric intensive care and procedural sedation","volume":"15","author":"Buck","year":"2010","unstructured":"Buck ML. Dexmedetomidine use in pediatric intensive care and procedural sedation. J Pediatr Pharmacol Ther. 2010;15(1):17\u201329."},{"issue":"5","key":"i2331-348X-30-5-623-b11","series-title":"Horm Res Paediatr","first-page":"300","article-title":"Pharmacokinetics and pharmacodynamics of orally administered clonidine: a model-based approach","volume":"79","author":"Klein","year":"2013","unstructured":"Klein RH, Alvarez-Jimenez R, Sukhai RN, et al. Pharmacokinetics and pharmacodynamics of orally administered clonidine: a model-based approach. Horm Res Paediatr. 2013;79(5):300\u2013309."},{"key":"i2331-348X-30-5-623-b12","article-title":"Medication Errors and Adverse Drug Events","year":"2019","unstructured":"Patient Safety Network. Medication Errors and Adverse Drug Events. 2019. 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Accessed September 6, 2025. https:\/\/www.ihi.org\/library\/white-papers\/ihi-global-trigger-tool-measuring-adverse-events"}],"container-title":["The Journal of Pediatric Pharmacology and Therapeutics"],"original-title":[],"link":[{"URL":"https:\/\/jppt.kglmeridian.com\/view\/journals\/jppt\/30\/5\/article-p623.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/jppt.kglmeridian.com\/downloadpdf\/journals\/jppt\/30\/5\/article-p623.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/jppt.kglmeridian.com\/downloadpdf\/journals\/jppt\/30\/5\/article-p623.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T22:04:07Z","timestamp":1763762647000},"score":1,"resource":{"primary":{"URL":"https:\/\/jppt.kglmeridian.com\/view\/journals\/jppt\/30\/5\/article-p623.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10]]},"references-count":13,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.5863\/jppt-24-00084","relation":{},"ISSN":["2331-348X","1551-6776"],"issn-type":[{"value":"2331-348X","type":"electronic"},{"value":"1551-6776","type":"print"}],"subject":[],"published":{"date-parts":[[2025,10]]}}}