Question | Answer |
Define toxidrome | A toxic syndrome made up of a constellation of signs and symptoms that consistently result from a particular toxin. |
What are common toxidromes? | Cholinergic
Anticholinergic
Narcotic/Opioid
Sedative/Hypnotic
Sympathomimetics
Hallucinogenics |
What characterises cholinergic toxidromes? | Elevated levels of acetycholine. |
What are examples of cholinergics? | Nicotine and mushrooms. |
What are examples of anticholinesterases? | Organophosphates
Carbamate insecticides
Nerve gas (sarin)
Urethanes |
What is the mnemonic for remembering cholinergic toxidromes's symptoms? | DUMBELS |
What does the mnemonic DUMBELS stand for? | D-iaphoresis.
U-rination.
M-iosis.
B-ronchorrhea, broncheospasm,bradycardia.
E-mesis, excitation of skeleteal muscle.
L-acrimation.
S-alivation,seizures. |
What is the management of cholinergic toxidromes? | Atropine and supportive ABC's. |
What is the definition of an anticholinergic drug? | A drug that generally interferes with the binding of acetycholine to muscarinic receptors. |
What does the administration of anicholinergic drugs result in? | The inhibition or blockage of the parasympathetic nervous system. |
What are examples of anticholinergic drugs? | Atropine
Anithistamines
Antipsychotics
Antiparkinsons
TCA's - Tricyclic antidepressants |
What are the symptoms of the anticholinergic toxidrome? | Altered LOC - agitation, hallucinations.
Mydriasis and blurred vision
Hot,dry,flushed skin- hyperthermia
Dry mucus membranes
Tachycardia, palpations, arrythmias
Urinary retention, decreased bowel sounds |
What is the management of the anticholinergic toxidrome? | Support ABC
Monitor ECG
IV |
Define sympomemetic toxidrome. | A toxidrome that mimics the sympathetic nervous system effects. |
What toxidrome is produced when a pt is withdrawing from alcohol or drugs? | Sympathomimetic toxidrome. |
Whithdrawal from what drugs may produce a sympathomimetic woxidrome? | Caffine
Cocaine
Amphetamine
LSD
Ecstacy
Theophylline |
What is an easy way of telling between anticholinergic and sympathomimetic toxidromes? | Anticholinergic - flushed, dry skin, no sweating.
Sympathomimetic - pale skin, diaphoresis. |
What is the mnemonic for remembering the symptoms of sympathomimetic toxidromes? | THIRDS. |
What does the mnemonic THIRDS stand for? | T-achycardia
H-yperthermia
I-ncreased motor activity
R-estlessness
D-ilated pupils
S-weating |
What is the management for sympathomimentic toxidromes? | Supportive ABCs
Cooling as required
Monitor ECG
IV
Consider 0.9 NaCl infusion. |