Serotonin syndrome results from drug-induced over-stimulation of serotonin receptors in the CNS and is characterized by a triad of CNS dysfunction, autonomic disturbance and neuromuscular effects; aka serotonin toxicity
Anticholinergic Toxidrome was one of the first flashcards I designed. I wanted to make a play on the old mnemonic: mad as a hatter, hot as hell, red as a beat, dry as a bone, and blind as a bat.
Cholinergic Toxidrome was the first flashcard I created, and forever encapsulates Travis as “the guy on the toilet”
A 41-year old man is brought to ED after becoming drowsy while in police custody. He states that he has taken an overdose of diazepam tablets prior to being arrested. A puzzling case of drug-induced delirium. Can you solve the mystery?
Sedative toxidrome: agents - opioids; benzodiazepines; barbiturates; baclofen (may mimic brain death, suspect in MS patients); clonidine (mimics opioid toxidrome with marked bradycardia and hypotension) GHB
True sympatholytic agents (e.g. alpha-blockers like phentolamine, and vasodilatory agents such as GTN, SNP, etc)≥ Also beta-blocker; ca2+ blocker; clonidine; digoxin
Abnormal vital signs in patient's following toxic exposures can suggest underlying toxidromes. Differential diagnosis of abnormal signs
Malignant Hyperthermia = pharmacogenetic disease of skeletal muscle induced by exposure to certain anaesthetic agents; incidence 1:5,000 -> 1:65,000 anaesthetics (suspected); mutation in the gene coding for the ryanodine receptor
Toxidromes associated with hyperthermia may be difficult to distinguish: serotonin syndrome; anticholingeric syndrome; sympathomimetic syndrome; neuroleptic malignant syndrome; malignant hyperthermia