Common Toxic Syndromes
Syndrome | Symptoms | Common Causes |
|---|---|---|
Anticholinergic | Tachycardia, hyperthermia, mydriasis, warm and dry skin, urinary retention, ileus, delirium (“mad as a hatter, blind as a bat, red as a beet, hot as a hare, and dry as a bone”*) | Antihistamines Belladonna alkaloids Datura (angel's trumpet) Jimson weed Psychoactive drugs (many) Tricyclic antidepressants |
Cholinergic, muscarinic | Salivation, lacrimation, urination, defecation, GI cramps, emesis (mnemonic device: SLUDGE) or Diarrhea; urination; miosis; bronchorrhea, bradycardia, and bronchoconstriction; emesis; lacrimation; and salivation (mnemonic device: DUMBELS) Wheezing | Carbamates |
Cholinergic, nicotinic | Mydriasis, tachycardia, weakness, hypertension and hyperglycemia, fasciculations, sweating (mnemonic device: MTWT[h]FS) Abdominal pain, paresis | Black widow spider bites Carbamates Organophosphates (some) |
Opioid | Hypoventilation, hypotension, miosis, sedation, possibly hypothermia | |
Sympathomimetic | Tachycardia, hypertension, mydriasis, agitation, seizures, diaphoresis, hyperthermia, psychosis (after chronic use) | Herbal and synthetic marijuana and common substitutes Phenylpropanolamine |
Withdrawal | Tachycardia, mild hypertension, mydriasis, diaphoresis, agitation, restlessness, anxiety, hyperreflexia, piloerection, yawning, abdominal cramps, lacrimation, flu-like symptoms, insomnia, vomiting and diarrhea | Withdrawal from the following sedating or recreational drugs: |
Agitation, hallucinations, confusion, disorientation, seizures, hyperreflexia, hypertension, tachycardia, arrhythmias, dehydration, autonomic instability, death | Withdrawal from the following drugs with sedative-hypnotic effects: | |
Decreased mental alertness, lethargy, coma, decreased blood pressure, decreased heart rate | Withdrawal from the following drugs with sympathomimetic effects: | |
Mild flu-like symptoms, insomnia, restlessness and anxiety | Withdrawal from the following drugs with antidepressant effects: | |
* From Carroll L: Alice's Adventures in Wonderland. London, MacMillan & Co., 1865. | ||
GHB = gamma-hydroxybutyrate; MDMA = methylenedioxymethamphetamine; MAOI = monoamine oxidase inhibitor; PCP = phencyclidine; SSRI = selective serotonin reuptake inhibitor. | ||