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Toxidromes

Common toxidromes

 

Cholinergic (Examples: organophosphates, carbamates, pilocarpine)
(DUMBELLS)

  • Diarrhea, diaphoresis
  • Urination
  • Miosis
  • Bradycardia, bronchosecretions
  • Emesis
  • Lacrimation Lethargic
  • Salivation

Nicotinic (recalled by the days of the week)

  • Monday: Miosis
  • Tuesday: Tachycardia
  • Wednesday: Weakness
  • Thursday: Tremors
  • Friday: Fasciculations
  • Saturday: Seizures
  • Sunday: Somnolent
  • Anticholinergic (Examples: antihistamines, cyclic antidepressants, atropine, benztropine, phenothiazines, scopolamine)
    Hyperthermia (HOT as a hare)
  • Flushed (RED as a beet)
  • Dry skin (DRY as a bone)
  • Dilated pupils (BLIND as a bat)
  • Delirium, hallucinations (MAD as a hatter) Tachycardia
  • Urinary urgency and retention
  • Sympathomimetic (Examples: cocaine, amphetamines, ephedrine, phencyclidine, pseudoephedrine)
  • Mydriasis
  • Tachycardia
  • Hypertension
  • Hyperthermia
  • Seizures

Opioid (Examples: heroin, morphine, codeine, methadone, fentanyl, oxycodone, hydrocodone)

  • Miosis
  • Bradycardia
  • Hypotension
  • Hypoventilation
  • Coma

Withdrawal

  • Diarrhea
  • Mydriasis
  • Goose flesh
  • Tachycardia
  • Lacrimation
  • Hypertension
  • Yawning
  • Cramps
  • Hallucinations
  • Seizures (with alcohol and benzodiazepine withdrawal)
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