toxidromes

Question 1

whole bowel irrigation for

Answer 1

CCBs, lithium, body packers

Question 2

opioid

Answer 2

+ propoxyphene, clonidine, imidazolidines, tramadol: pinpoint pupils, respiratory depression, lethargy/coma, dradycardia, hypothermia, borderline hypotension

Question 3

anti-cholinergic

Answer 3

diphenhydramine, antiPD/inticholinergic meds (benztropine), plant/herbal products (e.g. toxic jimsonweed): “blind as a bat, mad as a hatter, red as a beet, hot as a hare, full as a tick, dry as a bone, the bowel loses tone, and the heart runs alone” = mydriasis, AMS/delirium, flushing, hyperthermia, urinary retention, dry eyes/skin, decreased bs, tachycardia

Question 4

sympathomimetics

Answer 4

cocaine, amphetamines, anorectics, otc stimulants, “herbal” stimulants: same as anticholinergic: tachycardia, hyperthermia, mydriasis. unique: HTN, hyperactive vowels, diaphoresis

Question 5

cholinergic

Answer 5

organophosphates, carbamates (e.g. pesticides, donepezil), physostigmine, pyridostigmine, nerve gas: DUMBBELLS: diarrhea/diaphoresis, urination, miosis, bradycardia, bronchorrhea, emesis, lacrimation, salivation/seizures, + AMS, fasciculations, weakness (or SLUDG)

Question 6

sedative-hypnotic

Answer 6

anticonvulsants, barbituates, benzos, GHB, methaqualone, ethanol: deterioration of CNS fxn: ataxia, blurred vision, coma confusion, delirium, diplopia, dysesthesia, hallucination, nystagmus, paresthesia, sedation, slurred speech, stupor, apnea. most are anticonvulsant but GHB and methaqualone lower seizure threshold leading to paradoxical seizures