Sympathomimetic toxicity: Difference between revisions
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==Complications== | ==Complications== | ||
*[[Rhabdomyolysis]] is common complication <ref name="tox">O'Connor AD, Padilla-Jones A, Gerkin AD, et al. Prevalence of Rhabdomyolysis in Sympathomimetic Toxicity: a Comparison of Stimulants. J Med Toxicol 2015;11(2)195-200</ref> | *[[Rhabdomyolysis]] is common complication <ref name="tox">O'Connor AD, Padilla-Jones A, Gerkin AD, et al. Prevalence of Rhabdomyolysis in Sympathomimetic Toxicity: a Comparison of Stimulants. J Med Toxicol 2015;11(2)195-200</ref> | ||
**[[Bath Salts]] - 63% <ref name="tox"></ref> | |||
*[[Bath Salts]] - 63% <ref name="tox"></ref> | **[[Amphetamines]] - 40% | ||
*[[Amphetamines]] - 40% | **[[Cocaine]] - 33% | ||
*[[Cocaine]] - 33% | |||
==See Also== | ==See Also== |
Revision as of 12:23, 14 October 2016
Types
Sympathomimetics
- Cocaine
- Amphetamines
- Synthetic cathinones (khat)
- Ketamine
- Ecstasy (MDMA)
- Synthetic cannabinoids
- Bath salts
Differential Diagnosis
Altered mental status and fever
- Infectious
- Sepsis
- Meningitis
- Encephalitis
- Cerebral malaria
- Brain abscess
- Other
Toxidrome Chart
Finding | Cholinergic | Anticholinergic | Sympathomimetic | Sympatholytic^ | Sedative/Hypnotic |
Example | Organophosphates | TCAs | Cocaine | Clonidine | ETOH |
Temp | Nl | Nl / ↑ | Nl / ↑ | Nl / ↓ | Nl / ↓ |
RR | Variable | Nl / ↓ | Variable | Nl / ↓ | Nl / ↓ |
HR | Variable | ↑ | ↑ (sig) | Nl / ↓ | Nl / ↓ |
BP | ↑ | ↑ | ↑ | Nl / ↓ | Nl / ↓ |
LOC | Nl / Lethargic | Nl, agitated, psychotic, comatose | Nl, agitated, psychotic | Nl, Lethargic, or Comatose | Nl, Lethargic, or Comatose |
Pupils | Variable | Mydriatic | Mydriatic | Nl / Miotic | |
Motor | Fasciculations, Flacid Paralysis | Nl | Nl / Agitated | Nl | |
Skin | Sweating (sig) | Hot, dry | Sweating | Dry | |
Lungs | Bronchospasm / rhinorrhea | Nl | Nl | Nl | |
Bowel Sounds | Hyperactive (SLUDGE) | ↓ / Absent | Nl / ↓ | Nl / ↓ |
- ^Consider Sympatholytic when looking at Sedative OD or someone who doesn't respond to Narcan
- Withdrawal from substances have the opposite effect
Management
- Sedation with a Benzodiazepine
Complications
- Rhabdomyolysis is common complication [1]
- Bath Salts - 63% [1]
- Amphetamines - 40%
- Cocaine - 33%