Toxodromes

Question 1

Agitation, blank stare/catatonia, nystagmus

Answer 1

PCP

Question 2

Sympathomimetic: tachycardia, tachypnea, HTN, hyperthermia, myadriasis, diaphoresis, inc bowel sounds;
seizures and wide-complex dysrhythmias if severe

Answer 2

OD: Cocaine, amphetamines, decongestants
Tx: supportive, benzodiazepines for agitation, HTN, and hyperthermia

Vs. Anti-cholinergic (similar but pts will be dry rather than sweaty)

Question 3

Agitation/pressured speech, tachycardia, diarrhea, shivering, diaphoresis, myadriasis, clonus/reflexes 3+ (lower>upper), tremor, seizure

Answer 3

Serotonin syndrome 2/2: SSRI, neuroleptic, MDMA/ecstasy, MAOIs, cocaine, merperidine, dextromethorphan

Tx: cyproheptadine, benzodiazepines, hydration/cooling

Question 4

Coma, convulsions, cardiac dysrhythmias

Plus anti-cholinergic sx

Answer 4

TCAs –> QTc prolongation (wide QRS) –> torsades

Tx: sodium bicarbonate for TCA
Mg sulfate for torsades
Diazepam for seizures

Question 5

HA, flushing, tachycardia, palpitations, n/v within 12 hours of alcohol consumption

Answer 5

Disulfiram-like rxn 2/2 combining metronidazole with ethanol. MTZ (disulfiram) inhibits aldehyde DH, causing a build up of acetaldehyde —> sx.

Question 6

Diaphoresis, n/v, tachypnea, tachycardia, AMS, tinnitus

Respiratory alkalosis, metabolic acidosis (incr lactate 2/2 decoupled oxidative phosphorylation)

Answer 6

Salicylate (e.g. ASA poisoning)

Tx: sodium bicarbonate