Toxidromes
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| Define toxidrome | A toxic syndrome made up of a constellation of signs and symptoms that consistently result from a particular toxin.
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| What are common toxidromes? | Cholinergic
Anticholinergic
Narcotic/Opioid
Sedative/Hypnotic
Sympathomimetics
Hallucinogenics
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| What characterises cholinergic toxidromes? | Elevated levels of acetycholine.
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| What are examples of cholinergics? | Nicotine and mushrooms.
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| What are examples of anticholinesterases? | Organophosphates
Carbamate insecticides
Nerve gas (sarin)
Urethanes
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| What is the mnemonic for remembering cholinergic toxidromes's symptoms? | DUMBELS
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| 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.
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| What is the management of cholinergic toxidromes? | Atropine and supportive ABC's.
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| What is the definition of an anticholinergic drug? | A drug that generally interferes with the binding of acetycholine to muscarinic receptors.
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| What does the administration of anicholinergic drugs result in? | The inhibition or blockage of the parasympathetic nervous system.
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| What are examples of anticholinergic drugs? | Atropine
Anithistamines
Antipsychotics
Antiparkinsons
TCA's - Tricyclic antidepressants
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| 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
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| What is the management of the anticholinergic toxidrome? | Support ABC
Monitor ECG
IV
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| Define sympomemetic toxidrome. | A toxidrome that mimics the sympathetic nervous system effects.
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| What toxidrome is produced when a pt is withdrawing from alcohol or drugs? | Sympathomimetic toxidrome.
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| Whithdrawal from what drugs may produce a sympathomimetic woxidrome? | Caffine
Cocaine
Amphetamine
LSD
Ecstacy
Theophylline
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| What is an easy way of telling between anticholinergic and sympathomimetic toxidromes? | Anticholinergic - flushed, dry skin, no sweating.
Sympathomimetic - pale skin, diaphoresis.
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| What is the mnemonic for remembering the symptoms of sympathomimetic toxidromes? | THIRDS.
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| What does the mnemonic THIRDS stand for? | T-achycardia
H-yperthermia
I-ncreased motor activity
R-estlessness
D-ilated pupils
S-weating
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| What is the management for sympathomimentic toxidromes? | Supportive ABCs
Cooling as required
Monitor ECG
IV
Consider 0.9 NaCl infusion.
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