Poisoning / Overdose Syndromes

Signs & Symptoms which may or may not be present:

 

Merck Manual: Poisoning

 

Poison Control Online

 

Acetaminophen: initially no signs/symptoms or nausea/vomiting. If not detected and treated, may cause irreversible liver failure.

Antipsychotics (e.g. haloperidol and anti-emetics (e.g. prochlorperazine or metoclopramide) (Akathisia): feelings of anxiety, agitation, and jitteriness, as well as inability to sit still / pacing.

Anticholinergic (e.g. diphenhydramine, tricyclic antidepressants, bupropion): tachycardia, fever, dilated pupils, mental status changes. Blind as a bat (blurred vision). Dry as a bone (dry mouth). Red as a beet (flushing). Mad as a hatter (confusion). Hot as a hare (hyperthermia).

Aspirin/Salicylate: abdominal pain, vomiting, tachypnea, fever, altered mental status, tinnitus, hyperthermia, respiratory alkalosis, and metabolic acidosis. Late signs include renal dysfunction, liver failure, and or cerebral edema among.

Carbon monoxide (CO)headache, nausea, weakness, angina, dyspnea, loss of consciousness, seizures, and coma. 

Cardiac Medications: dysrhythmias, altered mental status, hypotension, hypoglycemia.

Depressants: bradycardia, hypotension, decreased temperature, decreased respirations, non-specific pupils.

Dystonic Reaction: Neurological movement disorder, in which sustained muscle contractions cause twisting and repetitive movements or abnormal postures. This may be induced by antipsychotics, such as haloperidol, or anti-emetics such as prochlorperazine or metoclopramide.

Opiate (e.g. heroin, fentanyl, morphine, oxycodone): Respiratory depression or arrest, pinpoint pupils, decreased mental states. Prolonged overdoses may result in compartment syndrome and/or hypothermia.

Organophosphates (e.g. fertilizer)(Nerve Agent Organophosphate Poisoning 2.13): bradycardia, increased secretions, nausea, vomiting, diarrhea, pinpoint pupils.

Solvents: nausea, coughing, vomiting, mental status change and arrhythmias. Patient with significant solvent exposure, must be handled gently to reduce the incident of arrhythmia and/ or subsequent cardiac arrest.

SSRIs (Serotonin Syndrome): Hyperthermia, agitation, ocular clonus (slow, continuous, horizontal eye movemens), tremor, dilated pupils, akathisia (see above), deep tendon hyperreflexia (common), muscle clonus (common), muscle rigidity, bilateral Babinski signs, dry mucus membranes, flushed skin and diaphoresis, ncreased bowel sounds.

Sympathomimetic/Stimulants: tachycardia, hypertension, seizures, agitation, increased temperature, dilated pupils, anxiety, paranoia, diaphoresis. Examples are bath salts, cocaine, methamphetamine, ecstasy, ADHD drugs, thyroid meds (rarely), salbutamol.

Tricyclics: seizures, dysrhythmias, hypotension, decreased mental status or coma.

 

Other Medications/Poisons

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