Section 9: Toxidromes Flashcards
Anticholinergic
Vitals:
Hyperthermia (hot as Hades), tachycardia, hypertensive, tachypnea
Mental Status:
Hypervigilant, agitated (mad as a hatter), hallucinating
Pupils:
Mydriasis (blind as a bat)
Other Findings:
*Dry flushed skin (dry as a bone, red as a beet), urinary retention
Examples:
Antihistamines, TCAs, atropine, scopolamine, antispasmodics
Cholinergic
Vitals:
Bradycardia (muscarinic), tachycardia and hypertensive (nicotinic)
Mental Status:
Confused, coma
Pupils:
Miosis
Other Findings:
SLUDGE (salivation, lacrimation, urination, diarrhea, GI upset, emesis)
Examples:
Organophosphate pesticides, nerve agents, physostigmine
Hallucinogen
Vitals:
Hyperthermia, tachycarida, hypertension
Mental Status:
Hallucinations, synesthesia, agitation
Pupils:
Mydriasis
Other Findings:
Nystagmus
Examples:
PCP, LSD, mescaline
Opioid
Vitals:
Hypothermia, bradycardia, hypotension, bradypnea
Mental Status:
CNS depression, coma
Pupils:
Miosis
Other Findings:
Hyporeflexia, pulmonary edema
Examples:
Opioids (heroin, morphine, methadone, dilaudid, etc.)
Sedative-Hypnotic
Vitals:
Hypothermia, bradycardia, hypotension, bradypnea
Mental Status:
CNS depression, confusion, coma
Pupils:
Miosis
Other Findings:
Hyporeflexia
Examples:
Benzos, barbiturates, alcohols
Serotonin Syndrome
Vitals:
Hyperthermia, tachycardia, hypertension, tachypnea
Mental Status:
Confused, agitated, coma
Pupils:
Mydriasis
Other Findings:
Tremor, myoclonus, *diaphoresis, hyperreflexia, trisumus, rigidity
Examples:
MAOIs, SSRIs, meperidine, dextromethorphan
Sympathomimetic
Vitals:
Hyperthermia, tachycardia, tachypnea
Mental Status:
Agitated, hyperalert, paranoia
Pupils:
Mydriasis
Other Findings:
Diaphoresis, tremors, hyperreflexia, seizures
Examples:
Cocaine, amphetamines, pseudoephedrine
Anticholinergic
HR ↑
Bowel sounds ↓ Urinary Retention Delirium Dry mouth Mydriasis Skin dry/warm/flushed
Examples:
Antihistamines, cyclic antidepressants, jimsonweed, cyclobenzaprine, scopolamine, atropine, benztropine, hyoscyamine, carbamazepine, oxybutynin, phenothiazines, atropine
Sympathomimetic
HR ↑
BP ↑
Agitated
Delirium
Mydriasis
*Skin diaphoretic
Examples:
Amphetamines, cocaine, phencyclidine, ephedrine, methylphenidate
Opioid
RR ↓ and/or shallow
Mental status ↓
Miosis
Examples:
Heroin, methadone, morphine, oxycodone, fentanyl, clonidine
Sedative-hypnotic
RR ↓ and/or shallow*
Mental status ↓
Examples:
Benzodiazepines, barbiturates, ethanol
Cholinergic
HR ↓
Bronchoconstriction Bronchorrhea Diaphoresis Lacrimation Miosis Salivation Urination
Examples:
Organophosphates, carbamates
