Toxidromes

• The term given to the syndrome observed when exposed to a toxin

Opioid

• Common toxidrome caused by exposure to opiate substances, commonly heroin
• Also includes prescribed opiates
• Signs: pinpoint pupils, reduced HR, reduced RR, reduced GCS

Anticholinergic

• Caused by tricyclics e.g. amitriptylline, antihistamines
• Signs: hyperthermia, agitated/hypervigilant, dilated pupils, drug flushed skin, tachycardia, hypertension, urinary retention
  • ‘Hot as Hades, mad as a hatter, blind as a bat, dry as as bone, red as a beet’

Cholinergic

• Uncommon toxidrome caused by organophosphate pesticides and some mushrooms
• Signs: confusion, miosis, bradycardia or tachycardia, SLUDGE (salivation, lacrimation, urination, diarrhoea, GI upset, emesis)

Sympathomimetic

• Caused by cocaine, amphetamines, MDMA, caffeine
• Signs: tachycardia, hypertension, hyperthermia, agitation, mydriasis, diaphoresis

Sedative/hypnotic

• Caused by benzodiazepines, barbituates, anxiolytics/sleeping tablets
• Signs: bradycardia, hypothermia, reduced respiratory rate, reduced GCS
  • Very similar to the opioid toxidrome but without the characteristic miosis

Summary