Toxidromes : Simple edition

 

Toxidromes are syndromes that patients experience when they overdose on certain class of medications. 

There are always typical signs and symptoms the patients experience you should look out for even when the patient could not tell you what they ingested. 

The treatment for toxidromes are requires some reading and it is imperative that you know the doses and when to start/stop treatment. Usually you would need to administer an antagonist drug to "go against" the overwhelming effect of the drug being overdosed. There are also drugs that could bind and remove the poison to be excreted or metabolised in the kidneys or liver. 

Here is a summary of what I have complied to simplify understanding regarding these syndromes. You will have to read further to understand the treatment. 

Explanation 

1. You will just need to know if the patient's PUPILS are dilated or constricted. A dilated pupil will correlate with heightened vital signs and vice versa, hence the vital signs are mainly for management.

2. If pupils are big (mydriasis), is the patient wet or dry? 

   Wet = Sympathomimetics, Dry = Anticholinergics.

- Sympathetics : Imagine running 5km and your heart will be racing, sweat dripping all over

- Anticholinergic : "Mad as a hatter, Blind as a bat, Dry as a bone, Red as a beet, Hot as a hare"

3. If pupils are small (mitosis),  is the patient wet or dry?

   Wet = Cholinergics, Dry = Opioids.

- Cholinergics : Cry, Pee, Poop. If you are sad or dislike someone, your pupils tend to constrict and you cry. You go on parasympathetic overdrive, so your gut muscles work harder.

- Opioids :  Gosh you just feel so high you shut out all light and you just want to be in that moment. Not a moment to spare to go to toilet. You could even forget to breath! 

You're happy so why would you cry?

4. If pupils are normal => Sedative overdose

 - EVERYTHING will be low.