# Accidental Ingestion of Extended-Release Guanfacine in a Toddler

## TL;DR

A healthy toddler accidentally ingested extended-release guanfacine, leading to a rare and severe complication requiring IV treatment.

## Contribution

This case report adds to the limited literature on persistent hypertension caused by extended-release guanfacine ingestion in children.

## Key findings

- The toddler experienced persistent hypertension requiring intravenous vasodilatory medication.
- The case highlights the rare and life-threatening complication of alpha-2 agonist ingestion in children.
- It expands the understanding of guanfacine's clinical effects when accidentally ingested.

## Abstract

This case report describes the clinical presentation and treatment following an exploratory ingestion of extended release (ER) guanfacine in a healthy toddler. Guanfacine, an alpha-2a agonist, can cause transient hypertension as it moves from the serum into the CNS where it causes the more commonly seen central nervous system (CNS) depression, hypotension, and bradycardia. Persistent hypertension requiring intravenous (IV) vasodilatory medication is a rare and life-threatening complication of an alpha-2 agonist with only one other published report. This case report re-emphasizes and further expands available literature on this rarely reported effect.