Toxidromes Flashcards
Management
1) ABCs, ECG, pO2
2) identify toxidrome
3) antidote
supportive care
intubation, IV fluids for hypotension, cardiac monitor with pO2, neuro assessment, glucose
5 basic toxidromes
sympathomimetics, opiate, anitcholinergic, cholinergic, sedative hypnotics
Sympathomimetics SX
hyperthermia, diaphoresis, myriasis, agitation, tachycardia, combativeness, hypertension
Caffeine lethal dose
150mg/kg
Caffeine OD
1) tremor, restlessness, NV, tachycardia, agitation
2) seizures, delirium, SVT, hypokalemia, hyperglycemia
3) HTN with low diastolic pressure
sympathomimetics
Caffeine, Cocaine, amphetamines, ephedrine
Opiates toxidrome
miosis, respiratory depression, CNS depression
Alice in Wonderland Syndrome
Micropsia- everything around you is smaller than it should be
Opioid TX
ventilation, Naloxone, NAC
Anitcholinergic toxidrome
diminished parasympathetic activity. Hot as Hades- fever Mad as a hatter- delerium Fast as a hare- tachycardia dry as a bone- anhidrosis red as a beet- flushing full as a tick- urinary retention Blind as a bat- mydriasis
anticholinergic TX
bzd, physostigmine
cholinergic toxidrome
increased parasympathetic activity (rest and Digest) DUMBB BELS Diarrhea Urinary incontinence Mioisis Bradycardia Bronchorrhea Bronchospasm Emesis Lacrimation Sweating, Salivation
Sed-Hypnotic toxidrome
CNS depression, lethargy
Serotonin Toxidrome
high temp, MS changes, autonomic instability, Neuromuscular abnormalites
Serotonin drugs
SSRI, prozac, antidepressants, selegiline, meperidine, dextromethorphan, dextroamphetamine, ecstasy, Triptans
Serotonin TX
Cyproheptadine, antipyretics, BZD
Flu-like symptoms that can lead to meningitis
anthrax
fever and leukocytosis, regional lymphadenitis, pneumonia, pharyngitis and cervical lymphadenitis
plague
acute onset fever, headache, myalgia, red spots followed by rash 1-4 days later, firm deep seated vesicles or pustules
small pox
diplopia, blurred vision, drooping eyelids, slurred speech, dry mouth, muscle weakness, symmetric descending paralysis
Botulism
cutaneous ulcer with regional lymphadenopaty
Ulceroglandular tularemia
regional lymphadenopathy with no ulcer
Glandular tularemia
conjunctivitis with preauricular lymphadenopathy
oculoglandular tularemia
stomatis or pharyngitis or tonsillitis and cervical lymphadenopathy
oropharyngeal tularemia
pleuropulmonary disease
pneumonic tularemia
flu like illness that progresses to NV
Viral hemorrhagic fever- Ebola, Marburg
