Recognisable poison syndromes
| Poison syndrome | Associated signs | Possible toxins |
|---|---|---|
| *Due to excessive cholinergic stimulation at the motor end plate. | ||
| Increased sympathetic nervous system activity (these features are common in disease generally) | Pyrexia Flushing Tachycardia Hypertension Pupillary constriction Sweating | Cough and decongestant preparations Amphetamines Cocaine Ecstasy Theophylline |
| Anticholinergic activity | Similar clinical picture to sympathomimetics Clinical differences include: Pupillary dilatation Dry mouth Hot dry skin | Tricyclic antidepressants Antiparkinsonian drugs Antihistamines Atropine and nightshade Antispasmodics Phenothiazines Mushroom poisoning (Amanita species) Cyclopentolate eye drops |
| Increased parasympathetic nervous system activity | Pupillary constriction Diarrhoea Urinary incontinence Sweating Excessive salivation Muscle weakness* Fasciculation* Paralysis* | Organophosphate insecticides Drugs for myasthenia gravis, e.g. pyridostigmine |
| Metabolic acidosis | Tachyopnoea Kussmaul breathing (sighing respiration) | Ethanol Carbon monoxide Antifreeze Iron Diabetic medication Tricyclic antidepressants Salicylates |
| Chemical pneumonitis | Cough Respiratory distress Central nervous system depression A history of vomiting following ingestion need not be a feature | White spirit Turpentine Essential oils |
| Acute ataxia or nystagmus | Antihistamines Alcohol Anticonvulsants (especially phenytoin and carbamazepine) Piperazine Diphenylhydantoin Barbiturates Carbon monoxide Organic solvents Bromides | |
| Methaemoglobinaemia | Cyanosis resistant to oxygen therapy | Alanine dyes Nitrates Benzocaine Phenacetin Nitrobenzene Chlorates Sulphonamides and metoclopramide (in neonates) |
| Renal failure | Oliguria or anuria Haematuria Myoglobinuria | Carbon tetrachloride Ethylene glycol Methanol Mushrooms Oxalates3 |
| Violent emesis | Aspirin Theophylline Corrosives Fluoride Boric acid Iron3 | |