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wikitox:3.2.1.3_toxidromes [2018/09/01 09:00] (current)
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 +Link to [[:​wikitox:​3.2.1.3_toxidromes_teaching_resources|3.2.1.3 Toxidromes Teaching Resources]]
 +
 +----
 +
 +====== Toxidromes ======
 +
 +See [[:​wikitox:​neuroleptic_malignant_syndrome|Neuroleptic Malignant Syndrome]]
 +
 +===== ANTICHOLINERGIC TOXIDROME =====
 +
 +(e.g. [[:​wikitox:​2.1.11.9.2_antidepressants|antidepressants]],​ [[:​wikitox:​2.1.11.9.3_antipsychotics|antipsychotics]],​ [[:​wikitox:​2.1.11.4.2_antihistamines|antihistamines]],​ [[:​wikitox:​datura|Brugmansia (Datura)]])
 +
 +  * Dry skin
 +  * Hyperthermia
 +  * Thirst
 +  * Dry mouth
 +  * [[:​wikitox:​pupil_size_and_reaction|Dilated pupils]]
 +  * Tachycardia
 +  * Urinary retention
 +  * Slowed gastric emptying
 +  * [[:​wikitox:​bowel_sounds|Decreased bowel sounds]]
 +  * [[:​wikitox:​3.2.1.1.5_hallucinations|Delirium]]
 +  * [[:​wikitox:​3.2.1.1.5_hallucinations|Hallucinations]]
 +
 +===== CHOLINERGIC TOXIDROME =====
 +
 +  * Muscarinic effects
 +  * Nicotinic effects
 +
 +See [[:​wikitox:​2.2.7.4.5_organophosphates|organophosphates]] and [[:​wikitox:​2.2.7.4.1_carbamates|carbamates]].
 +
 +==== Muscarinic effects ====
 +
 +  * defaecation
 +  * urination
 +  * miosis (small pupils)
 +  * bradycardia
 +  * emesis
 +  * lachrymation
 +  * increased secretions
 +  * sweating
 +
 +==== Nicotinic effects ====
 +
 +  * tachycardia
 +  * hypertension
 +  * muscle fasciculation
 +  * paralysis
 +
 +===== OPIOID TOXIDROME =====
 +
 +(e.g. heroin, morphine, methadone, codeine)
 +
 +  * CNS depression
 +  * Hypoventilation
 +  * Hypotension
 +  * Miosis
 +  * Pulmonary oedema
 +  * Rapid response to naloxone
 +
 +Also see [[:​wikitox:​3.2.1.1.4_unconsciousness|differential diagnosis of coma]] and explore the [[:​wikitox:​2.1.1.3_opioids|opioid module]].
 +
 +===== SYMPATHOMIMETIC TOXIDROME =====
 +
 +(e.g. amphetamines,​ [[:​wikitox:​2.1.11.4.8.2_theophylline|theophylline]],​ salbutamol, [[:​wikitox:​2.1.11.4.8.1_cocaine|cocaine]])
 +
 +  * CNS excitation
 +  * Seizures
 +  * Tremor
 +  * Hyperreflexia
 +  * Hyper/​hypotension
 +  * Tachycardia
 +  * Low potassium, raised blood glucose, acidosis
 +
 +Also, see [[:​wikitox:​3.2.1.1.9_differential_diagnosis_of_sympathomimetic_syndrome|differential diagnosis of sympathomimetic syndrome]]
 +
 +and explore [[:​wikitox:​2.1.11.4.8.2_theophylline|Theophylline]],​ [[:​wikitox:​2.1.11.9.2.2_monoamine_oxidase_inhibitors|MAO ]][[:​wikitox:​2.1.11.9.2.2_monoamine_oxidase_inhibitors|Inhibitor]] and [[:​wikitox:​2.1.11.4.8.1_cocaine|Cocaine]]
 +
 +
 +===== SEROTONERGIC TOXIDROME =====
 +
 +e.g. [[:​wikitox:​2.1.11.9.2.2_monoamine_oxidase_inhibitors|MAO inhibitors]],​ [[:​wikitox:​2.1.11.9.2.1_tricyclic_antidepressants|clomipramine]],​ [[:​wikitox:​2.1.11.9.2.3_serotonin_reuptake_inhibitors|SSRIs]],​ tryptophan (particularly in combination).
 +
 +A primary neuroexcitation spectrum of toxicity involving predominantly 5-HT2 receptors with abnormalities of
 +
 +  * Mental status
 +      * agitation/​restlessness/​confusion/​hypomania
 +  * Motor system
 +      * clonus/​myoclonus
 +        * inducible/​spontaneous/​ocular
 +      * tremor/​shivering
 +      * hyperreflexia/​hypertonia/​rigidity
 +  * Autonomic nervous system
 +      * diaphoresis/​tachycardia/​flushing/​mydriasis
 +
 +Explore [[:​wikitox:​serotonin_toxicity_detailed_article|serotonin toxicity]] module \\
 +Explore [[:​wikitox:​2.1.11.9.2.2_monoamine_oxidase_inhibitors|MAO inhibitor]] module \\
 +Explore [[:​wikitox:​2.1.11.9.2.3_serotonin_reuptake_inhibitors|selective serotonin reuptake inhibitor]] module \\
 +Explore [[:​wikitox:​2.1.11.9.2.1_tricyclic_antidepressants|tricyclic antidepressant]] module
 +
  
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