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wikitox:3.2.1.1.4_unconsciousness [2018/09/01 09:00] (current)
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 +===== UNCONSCIOUSNESS =====
 +
 +There are a large number of toxins that can lead to coma of which the most common (in Australia) are:
 +
 +  * [[:​wikitox:​benzodiazepines|Benzodiazepines]]
 +  * [[:​wikitox:​2.1.11.9.2.1_tricyclic_antidepressants|Tricyclic antidepressants (TCAs)]]
 +  * [[:​wikitox:​2.1.11.9.3_antipsychotics|Neuroleptics]]
 +  * [[:​wikitox:​2.1.11.2_anticonvulsants|Anticonvulsants]]
 +  * [[:​wikitox:​2.1.11.5.1_acute_management_of_alcohol_problems|Alcohol]]
 +  * [[:​wikitox:​2.1.1.3_opioids|Opioids]]
 +
 +In addition there are a number of less common toxins, which are important to diagnose as they have severe effects and specific treatment.
 +
 +  * [[:​wikitox:​2.1.11.9.4_mood_stabilizers|Lithium]]
 +  * [[:​wikitox:​barbiturates|Barbiturates]]
 +  * [[:​wikitox:​2.1.11.9.1_miscellaneous_anxiolytics_and_sedative_hypnotics|Chloral hydrate]]
 +  * [[:​wikitox:​2.1.7.1.2_sulphonylureas|Hypoglycaemic drugs]] and [[:​wikitox:​2.1.7.1.1_insulin|insulin]]
 +  * [[:​wikitox:​2.2.7.4.5_organophosphates|Organophosphates]]
 +  * Toxic alcohol ([[:​wikitox:​2.2.5.2.5_methanol|methanol]],​ [[:​wikitox:​2.2.5.2.2_ethylene_glycol|ethylene glycol]] & isopropanol)
 +  * [[:​wikitox:​2.2.9.1.1_carbon_monoxide|Carbon monoxide (CO)]]
 +
 +Clearly, there are also large numbers of other drugs that may lead to impairment of consciousness by reducing cerebral blood flow or causing seizures. These will not be discussed here.
 +
 +Features that help to differentiate between these drugs are:
 +
 +  * [[:​wikitox:​response_to_painful_stimuli|Response to Painful Stimuli]]
 +  * [[:​wikitox:​pupil_size_and_reaction|Pupil Size and Reaction]]
 +  * [[:​wikitox:​myoclonic_jerking_or_hyperreflexia|Myoclonic Jerking or Hyperreflexia]]
 +  * [[:​wikitox:​nystagmus|Nystagmus]]
 +  * [[:​wikitox:​odour|Odour]]
 +  * [[:​wikitox:​heart_rates|Heart Rate]]
 +  * [[:​wikitox:​bowel_sounds|Bowel Sounds]]
 +  * [[:​wikitox:​ecg_changes|ECG Changes]]
 +  * Response to Antagonists
 +  * [[:​wikitox:​electrolytes_and_blood_glucose|Electrolytes and Blood Glucose]]
 +  * [[:​wikitox:​drug_monitoring|Blood Concentrations]]
 +
  
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