Oral clonidine may be a safe and effective sedative in combination with morphine and lorazepam for young children with single-organ, respiratory failure. This agent may also exhibit opioid and benzodiazepine sparing effects in this patient group. A full pharmacokinetic study is warranted.

High dose clonidine administered via different routes can be used in the acute management of severe exacerbations of dystonia. Its use in our cohort was not associated with significant cardio-respiratory depression even at doses as high as 9 mcg/kg/h.

Our series Prescribing in children gives practical advice for successful management of childhood problems in general practice. Here, the author describes how the problems of compliance with medicines‐taking can be overcome. Copyright © 2007 Wiley Interface Ltd

Our findings mirror those of previously published studies with an adult focused counselling set,these concluded that less than 10% of healthcare professionals were competent with an MDI.1 Though respiratory conditions represent a large proportion of paediatric consultants, healthcare staff are failing to equip patients and carers with the knowledge and skills to utilise even the most common inhaler devices. With the NHS spending £900 million on inhalers2 and hospital admissions increasing dramatically3 more needs to be done to improve inhaler literacy within the local healthcare community.A comprehensive review of training methods needs to be undertaken to ensure these meet the requirements of the local healthcare community. A renewed emphasis on asthma care is required including standard methods for counselling on inhalers.A competency document should be created to assess and validate healthcare professionals to ensure the delivery of accurate and high quality inhaler counselling.