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Old 07-05-2011
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Steps History: 1+CK+CS
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Drug Drug Toxicities

  1. Hypertension with tachycardia: amphetamines, cocaine, antimuscarinics
  2. Hypotension and bradycardia: beta blockers, calcium channel blockers, clonidine, sedative-hypnotics
  3. Hypotension with tachycardia: tricyclic antidepressants, phenothiazines, theophylline (acute), β-agonists
  4. Rapid respiration: salicylates, carbon monoxide, chemicals producing metabolic acidosis or cellular asphyxia (cyanide)
  5. Hyperthermia: sympathomimetics, anticholinergics, salicylates, uncouplers of oxidative phosphorylation (dinitrophenol), chemicals producing seizures or muscular rigidity
  6. Hypothermia: phenothiazines, ethanol, and other sedatives
  7. Eyes
    • Pupil constriction (miosis): opioids, phenothiazines (α-blockade), cholinesterase inhibitors, alpha blockers
    • Pupil dilation (mydriasis): amphetamines, cocaine, lysergic acid diethylamide (LSD), anticholinergics, phencyclidine (PCP)
  8. Skin
    • Flushed, hot, and dry: atropine, antimuscarinics
    • Excessive sweating: cholinesterase inhibitors, sympathomimetics, nicotine
  9. Cyanosis: hypoxemia, methemoglobinemia (nitrites)
  10. Jaundice (liver toxicity): acetaminophen, erythromycin estolate (cholestatic), carbon tetrachloride, troglitazone, valproic acid
  11. Abdomen
    • Ileus: typical of antimuscarinics, opioids, and sedatives
    • Hyperactive bowel sounds, cramping, and diarrhea: common with organophosphates, iron, arsenic, theophylline, and mushrooms
  12. Nervous system
    • Twitching and muscular hyperactivity: anticholinergics, sympathomimetics, cocaine
    • Muscular rigidity: antipsychotics (especially haloperidol), strychnine, fentanyl
    • Seizures (treat with intravenous diazepam or lorazepam): theophylline, isoniazid, cocaine, amphetamines, tricyclics, diphenhydramine, lidocaine, meperidine
    • Flaccid coma: opioids, sedative/hypnotics, central nervous system depressants
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Ace3 (07-05-2011), jahn77 (07-13-2011), monsalg2502 (12-02-2011)



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