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Common Toxidromes and Causes
Alcohol withdrawal
-tremors beginning in firrst 5 to 10 minutes
-seizures aregenerelized and are typicalyisolated or occur in a brief flurry
beginning at 6 to 48 hours after reduced intake. Focal or protracted seizures
are atypical and waarant investigation
-delirium tremens (DT) in some patients after several days

Note: Sedative Hypnotic withdrawal has similar manifestations but with a different time course that varies with the half life of the agent involved
Anticholinergic toxidrome
-altered mental status (hallucinations, agitation, coma)
-large pupils
-dry skin
-decreased bowel sounds
-urinary retention
-antihistamines (Benadryl- Diphenhydramine, Gravol -  Dimenhydrinate)
-anticholinergic plants (e.g., Jimson weed, Atropa beladona)
-cyclic antidepressants
-antiparkinsonian agents
Benzodiazepine/sedative hypnotic toxidrome
-depressed mental status
-relatively small pupils
-vital signs usually normal
-significant respiratory depression is rare with pure benzodiazepine overdose
-hypotension in large ingestions

-overdose of benzodiazepines
-some sedative hypnotics
Cholinergic toxidrome
-lacrimation, salivation
-respiratory secretions
-increased bowel sounds
-diarrhea and urinary incontinence
-fasciculations may accur and muscle weakness can result  in respiratory failure
-organophosphate and acrbamate insectides
Opiate toxidrome
-respiratory depression
-depressed mental status
-small pupils
-slight bradycardia (unless hypoxic or hypovolemic)
-prompt response to naloxone hydrochloride
-overdose of heroin & other opiates
Phenothiazine toxidrome
-depressed mental status
-small pupils
-do not respond to naloxone hydrochloride
-overdose of phenthiazines
Sympathomimetic toxidrome
-elevated vital signs
-agitated delirium is common
-large pupils
-diaphoresis (unless severely dehydrated)
-bowel sounds present

*Note: This toxidrome is usually differentiated from the anticholinergic toxidrome by the presence of marked diaphoresis (instead of dry skin). Also bowel sounds are not decreased.
-overdose of cocaine or amphetaminea
-alcohol or sedative hypnotic withdrawal results in simialr      findings
Serotonin syndrome

Notes: 1. shivering, rigidity, myoclonus and hyperreflexia usually differentiated this syndrome from the sympathomimetic toxidrome (+ history of the drugs that were ingested). 2. DD: Amphetamines overdose (e.g. MDMA,PMA), Cocaine overdose, Malignant hyperthermia,
-Serotonin Reuptake Inhibitors (SSRIs), Meperidin (Demerol), Fluexitin (Prozac), or other serotonin-enhancing drug ----- especially when a patient taking an MAO inhibitors ingests SSRI

Selected drugs in which minimal ingested dose may cause severe intoxication in a child
Calcium blockers, Beta blockers, Clonidine, Tricyclic antidepressants, Oral hypoglicemic drugs, Methanol/Ethylen glycol,