Toxin

Toxidrome

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Toxidrome, Common Patterns in Toxicology, Poisoning Syndrome

  • See Also
  1. Unknown Ingestion
  2. Poisoning Causes
  3. Date Rape Drug
  4. Toxin Induced Vital Sign Changes
  5. Toxin Induced Skin Changes
  6. Toxin Induced Neurologic Changes
  7. Toxin Induced Odors
  8. Eye Examination Signs of Chemical Dependency
  • Definitions
  1. Toxidrome
    1. Constellation of findings after toxin group exposure
  • Causes
  • Autonomic Toxidromes
  1. Anticholinergic Toxicity (Antimuscarinic Poisoning, e.g. Diphenhydramine)
    1. Blood Pressure increased
    2. Heart Rate increased
    3. Body Temperature increased
    4. Skin hot and dry (contrast with diaphoretic in Sympathomimetic and Cholinergic Toxicity)
    5. Mydriasis
    6. Ataxia, Agitated Delirium
  2. Cholinergic Toxicity (e.g. Organophosphate Poisoning, Nerve Agent Exposure)
    1. Variable Vital Signs and pupil size
    2. Diaphoresis
    3. Bronchorrhea
    4. Muscle Fasciculations
  3. Sympathomimetic Toxicity (e.g. Cocaine, Amphetamines, Psychoactive Bath Salts)
    1. Blood Pressure increased
    2. Heart Rate increased
    3. Body Temperature increased
    4. Tachypnea
    5. Diaphoresis (contrast with Anticholinergic Toxicity)
    6. Mydriasis
    7. Agitated Delirium, pressured speech, hyperreflexia
  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
  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
  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
  • References
  1. Holstege (2012) Crit Care Clin 28(4):479-98 +PMID: 22998986 [PubMed]
  2. Vega (2024) Am Fam Physician 109(2): 143-153 [PubMed]