II. Definitions

  1. Toxidrome
    1. Constellation of findings after toxin group exposure

III. Causes: Autonomic Toxidromes

IV. Causes: Opioids

  1. Opioid Overdose (or Opioid Intoxication, e.g. Heroin, Fentanyl)
    1. Blood Pressure decreased
    2. Heart Rate decreased
    3. Respiratory Rate decreased (or apnea)
    4. Miosis
    5. Hyporeflexia
  2. Opioid Withdrawal
    1. Heart Rate increased
    2. Mydriasis
    3. Diaphoresis, piloerection ("goose bumps")
    4. Hyperreflexia, Yawning, Restlessness, Tremor

V. Causes: Sedative Hypnotic

  1. Benzodiazepine Intoxication (e.g. Alprazolam)
    1. Normal Vital Signs
    2. Respiratory depression or apnea (typically with coingestion of Alcohol, Opioids, or other CNS Depressants)
    3. Altered Level of Consciousness (drowsiness to coma)
    4. Anterograde Amnesia, slurred speech, Ataxia
  2. Benzodiazepine Withdrawal
    1. Diaphoresis
    2. Tremor, anxiety, irritability, Insomnia
    3. Nausea, Diarrhea

VI. Causes: Serotoninergic

  1. Serotonin Syndrome
    1. Blood Pressure increased
    2. Heart Rate increased
    3. Body Temperature increased
    4. Tachypnea
    5. Diaphoresis
    6. Agitated Delirium, Hyperreflexia, Clonus
  2. Antidepressant Withdrawal
    1. Diaphoresis
    2. Paresthesias, Dizziness, anxiety, restlessness, Headache, generalized weakness, Insomnia
    3. Nausea, Diarrhea

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