That's so Toxic

Three to the 'Drome

100

Fentanyl, Heroin, Codeine

What are Opioids?

200

Xanax, GHB, Ethanol

What are Sedative-Hypnotics?

300

Cocaine, Ecstasy, Bath Salts (Synthetic Cathinones)

What are Sympathomimetics?

400

Organophosphates, Neostigmine, Donepezil

What are Cholinergic agents?

500

Linezolid, Tramadol, Duloxetine

What are Serotonergic agents?

Reverse, Reverse!

100

Supportive Care and Time are the companions on the road to recovery from this toxidrome.

What is Sedative-hypnotic?

200

Some Narcan in the nose, and people under this toxidrome may not be so pleased with you! (Don't forget to keep an eye on the airway and oxygenation!)

What is Opioid?

300

Atropine is cornerstone in treating this toxidrome.

What is Cholinergic?

400

In severe cases of this toxidrome, Cyproheptadine may be necessary. 

What is Serotonergic?

500

Benzodiazepines and an ice-water bath (in hyperthermic cases) are used to counteract this toxidrome.

What is Sympathomimetic?

So Many Arrows

100

 _{HR       BP       RR       Temp      Pupils       Skin} 

 _{↑         ↑/↓      ↑           ↑       Dilated      Dry & flushed}

What is Anticholinergic?

200

_{HR       BP       RR       Temp      Pupils       Skin}

_{↓          ↓          ↑/↓      ↔         Constricted  Wet}

What is Cholinergic?

300

_{HR       BP       RR       Temp      Pupils       Skin}

_{↑           ↑         ↑           ↑         Dilated      Wet}

_**Bonus**

What is Serotonergic? ~OR~ What is Sympathomimetic? 

400

_{HR       BP       RR       Temp      Pupils       Skin}

_{↓/↔      ↓/↔      ↓        ↓/↔       Constricted  Varies}

What is Opioid?

500

_{HR       BP       RR       Temp      Pupils       Skin}

_{↓/↔      ↓/↔      ↓/↔      ↓/↔      Varies     Varies}

What is Sedative-Hypnotic?

Voila, *Magic*!

100

This antidote competitively binds mu- receptors in the central nervous system.

What is Naloxone?

Bonus: (Opioid antidote)

200

This antidote is a competitive inhibitor of liver enzyme: alcohol dehydrogenase, and stops formation of toxic acids and crystals.

What is Fomepizole?

Bonus: (Toxic alcohol {ethylene glycol/methanol} antidote)

300

This antidote replenishes liver glutathione to neutralize toxic metabolic byproducts.

What is N-acetylcysteine?

Bonus: (Acetaminophen antidote)

400

This antidote competitively binds GABA_A receptor sites, reversing sedation and respiratory depression.

What is Flumazenil?

Bonus: (BZD antidote)

500

This antidote floods the blood, displacing toxic gas from hemoglobin.

What is 100% Oxygen?

Bonus: (Carbon monoxide antidote)

Get Your Mind Right

100

Confusion, Sedation, Coma, Hallucinations

**Bonus**

What are the predominantly Inhibitory toxidromes?

(Cholinergic, Opioid, Sedative-Hypnotic)

200

Agitation, Hypervigilance, Paranoia, Hyperactive Delirium, Confusion

**Bonus**

What are the predominantly Excitatory Toxidromes?

(Anticholinergic, Sympathomimetic, Hallucinogenic, Serotonergic)