Toxidrome
Definition
A reproducible cluster of clinical findings (vital signs, pupil size, skin, bowel and bladder, mental status) that identifies a class of poison from bedside examination alone, before any analytical confirmation.
- Assessed signs
- Vital signs, pupil size, skin, bowel/bladder, mental status
- Timing
- Available immediately, before lab confirmation
- Common examples
- Cholinergic, anticholinergic, opioid, sympathomimetic
- Purpose
- Identify a poison class from bedside exam alone
Common questions
What is the anticholinergic toxidrome often confused with?+
It can resemble the sympathomimetic toxidrome because both cause tachycardia and agitation. The distinguishing feature is skin and bowel activity: anticholinergic toxicity produces dry skin and absent bowel sounds, while sympathomimetic toxicity produces sweating and hyperactive bowel sounds.
Why do clinicians act on a toxidrome before lab results are back?+
Analytical confirmation can take hours a poisoned patient may not have. Antidotes such as naloxone for opioid toxicity or atropine for cholinergic toxicity are often started on the clinical pattern alone, then adjusted once test results arrive.
Related terms
- Antidote
- A substance that counteracts a poison by competitive receptor block, enzymatic reactivation, chelation, immune binding or substrate replacement. Antidotes are class-specific, not...
- Atropinisation
- The clinical end point of titrated atropine therapy in cholinergic poisoning: drying of pulmonary secretions, clearing of crepitations, heart rate above 80,...
- DUMBBELS
- Mnemonic for the muscarinic side of the cholinergic toxidrome: Diarrhoea, Urination, Miosis, Bronchospasm and Bronchorrhoea, Bradycardia, Emesis, Lacrimation, Salivation.
- Oxime Reactivation
- Restoration of acetylcholinesterase function by pralidoxime (2-PAM) or obidoxime through cleavage of the organophosphate-enzyme bond, effective only before the enzyme is irreversibly...
- Specific Antidote
- An agent that acts on the poison's mechanism, not just on its symptoms. Naloxone for opioids, NAC for paracetamol, methylene blue for...