II. Definitions
- Toxidrome
- Constellation of findings after toxin group exposure
III. Causes: Autonomic Toxidromes
-
Anticholinergic Toxicity (Antimuscarinic Poisoning, e.g. Diphenhydramine)
- Blood Pressure increased
- Heart Rate increased
- Body Temperature increased
- Skin hot and dry (contrast with diaphoretic in Sympathomimetic and Cholinergic Toxicity)
- Mydriasis
- Ataxia, Agitated Delirium
-
Cholinergic Toxicity (e.g. Organophosphate Poisoning, Nerve Agent Exposure)
- Variable Vital Signs and pupil size
- Diaphoresis
- Bronchorrhea
- Muscle Fasciculations
-
Sympathomimetic Toxicity (e.g. Cocaine, Amphetamines, Psychoactive Bath Salts)
- Blood Pressure increased
- Heart Rate increased
- Body Temperature increased
- Tachypnea
- Diaphoresis (contrast with Anticholinergic Toxicity)
- Mydriasis
- Agitated Delirium, pressured speech, hyperreflexia
IV. Causes: Opioids
-
Opioid Overdose (or Opioid Intoxication, e.g. Heroin, Fentanyl)
- Blood Pressure decreased
- Heart Rate decreased
- Respiratory Rate decreased (or apnea)
- Miosis
- Hyporeflexia
-
Opioid Withdrawal
- Heart Rate increased
- Mydriasis
- Diaphoresis, piloerection ("goose bumps")
- Hyperreflexia, Yawning, Restlessness, Tremor
V. Causes: Sedative Hypnotic
-
Benzodiazepine Intoxication (e.g. Alprazolam)
- Normal Vital Signs
- Respiratory depression or apnea (typically with coingestion of Alcohol, Opioids, or other CNS Depressants)
- Altered Level of Consciousness (drowsiness to coma)
- Anterograde Amnesia, slurred speech, Ataxia
- Benzodiazepine Withdrawal
VI. Causes: Serotoninergic
-
Serotonin Syndrome
- Blood Pressure increased
- Heart Rate increased
- Body Temperature increased
- Tachypnea
- Diaphoresis
- Agitated Delirium, Hyperreflexia, Clonus
- Antidepressant Withdrawal