Poisoning and Toxidromes Flashcards
What are the main alterations to mental status with sympathomimetic toxins?
- Hyperalert
- Agitation
- Hallucinations
- Paranoia
How do sympathomimetics alter pupil size?
Cause myadriasis
What changes to vital signs might you see in someone with sympathomimetic intoxication?
- Hyperthermia
- Tachycardia
- Hypertension
- Widened pulse pressure
- Tachypnoea
- Hypernoea
What are examples of sympathomimetic agents?
- Cocaine
- Amphetamines
- Cathinones
- Ephidrine
- Pseudoephedrine
- Theophylline
- Caffeine
What signs might you find in someone with sympathomimetic overdose other than changes in vital signs?
- Diaphoresis
- Tremors
- Hyperreflexia
- Seizures
What alterations to mental status occur in anticholinergic overdose?
- Hypervigilance
- Agitation
- Hallucinations
- Delerium with mumbling speech
- Coma
What changes occur to pupil size due to anticholinergic overdose?
Cause myadriasis
What changes to vital signs can anticholinergic toxicity cause?
- Hyperthermia
- Tachycardia
- Hypertension
- Tachypnoea
What signs might you see in someone with anticholinergic intoxication other than the changes you would see to vital signs?
- Dry flushed skin
- Dry mucous membranes
- DEcreased bowel sounds
- Urinary retention
- myoclonus
- Choreoathetosis
- Picking behaviour
- Seizures (rare)
What are examples of anticholinergic drugs which can cause anticholinergic toxidrome?
- Antihistamines
- TCA
- Antiparkinson agents
- Antispasmodics
- Phenothiazines
- Atropine
- Cyclobenzarine
What alterations to mental status can hallucinogenic intoxication cause?
- Hallucinations
- Perceptual distrotion
- Depersonalisation
- Synesthesia
- Agitation
What is the most common type of pupil change seen in hallucinogen intoxication?
Myadriasis
What changes to vital signs can hallucinogens cause?
- Hyperthermia
- Tachycardia
- Hypertension
- Tachypnoea
What signs might you see in someone with hallucinogen intoxication other than the changes seen to their vital signs?
Nystagmus
What are examples of hallucinogenic drugs which can cause hallucinogenic toxidrome?
- Phencyclidine
- LSD
- Mescaline
- Psilocybin
- MDMA
- MDEA
What changes to metnal status can sedative/hypnotic agents as part of the sedative/hypnotic toxidrome?
- CNS depression
- Confusion
- Stupor
- Coma
What are examples of sedative/hypnotic agents which cane cause toxidromes?
- Benzodiazepines
- Barbituates
- Carisoprodol
- Meprobamate
- Glutethimide
- Alcohols
- Zolpidem
What changes to pupil size can sedative/hypnotic agents cause?
Variable - either myosis or myadriasis
What changes to vital signs can hypnotic/sedative agents cause?
Often normal, but may develop
- Hypothermia
- Bradycardia
- Hypotension
- Apnoea
- Bradypnoea
What other signs might be evident when assessing someone with sedative/hypnotic intoxication other than changes to their vital signs?
Hyporeflexia
What changes to metnal status occur in opiod intoxication?
- CNS depression
- Coma
What change to pupil size occurs in opiod intoxication?
Miosis
What changes occur to vital signs in someone with opiod intoxication?
- Bradypnoea - apnoea characteristic
- Hypothermia
- Bradycardia
- Hypotension
Hypothermia, bradycardia and hypotension occur in large dose intoxication
What other signs can be seen in opiod intoxication besides changes seen to vital signs?
- Hyporeflexia
- Pulmonary oedema
- Needle marks
What are examples of opioids that cause intoxication?
- Heroin
- Morphine
- Methadone
- Oxycodone
- Hydromorphone
- Fentanyl
- RemyFentanyl
What changes to mental status can occur in cholinergic intoxication?
- Confusion
- Coma
What changes to pupil size would you see in cholinergic intoxication?
Miosis
What changes to vital signs might you see in cholinergic intoxication?
- BRadycardia
- Hyper/hypotension
- Tachypnoea/bradypnoea
What other signs can cholinergic intoxication cause other than observed changes to vital signs?
- Salivation
- Urinary/faecal incontinence
- Diarrhoea
- Emesis
- Diaphoresis
- Lacrimation
- GI cramps
- Bronchoconstriction
- Muscle fasciculations
- Weakness
- Seizures
What cholinergic drugs can cause chokinergic intoxication?
- Organophosphate/carbamate insecticides
- Nerve agents
- Nicotine
- Pilocarpine
- Physostigmine
- Edrophonium
- Bethanechol
- Urecholine
What changes to metnal status can occur in serotinin syndrome?
- Confusion
- Agitation
- Coma
What changes in pupil size occur in serotonin syndrome?
Myadriasis
What change in vital signs are often seen in serotonin syndrome?
- Hyperthtermia
- Tacycardia
- Hypertension
- Tachypnoea
What signs might you see other than changes to vital sign in serotonin syndrome?
- Tremor
- Myoclonus
- Hyperreflexia
- Clonus
- Diaphoresis
- FLushing
- Trismus
- Rigidity
- Diarrhoea
What toxidromes are associated with myadriasis?
- Hallucinogenic toxidrome (usually)
- Serotonin syndrome
- Sympathomimemtic toxidrome
- Anticholinergic toxidrome
What toxidromes are associated with miosis?
- Opiod toxidrome
- Cholinergic toxidrome
What toxidromes are associated with hyperthermia, hypertension, tachypnoea and tachycardia?
- Sympathomimetic toxidrome
- Anticholinergic toxidrome
- Hallucinogenic toxidrome
- Serotonin syndrome
What toxidrome often presents with respiratory depression?
Opioid toxidrome
