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Sympathomimetic Toxicity

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1. Antipsychotics for the treatment of sympathomimetic toxicity: A systematic review

Antipsychotics for the treatment of sympathomimetic toxicity: A systematic review Benzodiazepines are often recommended first-line for management of cocaine and amphetamine toxicity while antipsychotic treatment is discouraged due to the potential for lowering seizure threshold, prolonging the QT interval, and decreasing heat dissipation. We performed a systematic review including animal and human studies to elucidate the efficacy and safety of antipsychotics in managing sympathomimetic (...) toxicity specifically evaluating the effect of treatment on mortality, seizures, hyperthermia, and cardiovascular effects.We searched MEDLINE, Embase, BIOSIS Previews, Web of Science, Scopus, CENTRAL and gray literature from inception to 31 May 2017 to answer: Can antipsychotics be used safely and effectively to treat cocaine or amphetamine toxicity? Citations were screened by title and abstract. Additional citations were identified with citation tracking. Data were extracted from full-texts.6539

2019 EvidenceUpdates

2. Antipsychotics for the treatment of sympathomimetic toxicity: A systematic review. (PubMed)

Antipsychotics for the treatment of sympathomimetic toxicity: A systematic review. Benzodiazepines are often recommended first-line for management of cocaine and amphetamine toxicity while antipsychotic treatment is discouraged due to the potential for lowering seizure threshold, prolonging the QT interval, and decreasing heat dissipation. We performed a systematic review including animal and human studies to elucidate the efficacy and safety of antipsychotics in managing sympathomimetic (...) toxicity specifically evaluating the effect of treatment on mortality, seizures, hyperthermia, and cardiovascular effects.We searched MEDLINE, Embase, BIOSIS Previews, Web of Science, Scopus, CENTRAL and gray literature from inception to 31 May 2017 to answer: Can antipsychotics be used safely and effectively to treat cocaine or amphetamine toxicity? Citations were screened by title and abstract. Additional citations were identified with citation tracking. Data were extracted from full-texts.6539

2019 American Journal of Emergency Medicine

3. CRACKCast E154 – Cocaine and Other Sympathomimetics

in a patient presenting with a classic sympathomimetic toxidrome. NOTE: More severely toxic patients may be agitated, combative, and hyperthermic. Additionally, patients may present with focal acute pain syndromes, circulatory abnormalities, delirium, or seizures. Clonus does not occur with acute cocaine toxicity. NOTE: Typically, end organ damage is rare. However, if there is end-organ damage, it is manifested as an acute hypertensive emergency. [3] What are the mechanisms (routes) of cocaine exposure (...) -induced psychosis and agitation resulting from sympathomimetic agents. NOTE: Although lorazepam also can be given intramuscularly, it may take 15 minutes to reach peak sedation; repeated doses given at more frequent intervals may accumulate, causing oversedation and respiratory depression. NOTE: Safe antihypertensives to use in the patient with severe cocaine toxicity: Phentolamine Nitroglycerin Hydralazine Treatment of hyperthermia: NOTE: Patients who sustain elevated core temperatures above 106°F

2018 CandiEM

4. Sympathomimetic Toxicity

Sympathomimetic Toxicity Sympathomimetic Toxicity Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Sympathomimetic Toxicity (...) Sympathomimetic Toxicity Aka: Sympathomimetic Toxicity , Adrenergic Overdose , Sympathomimetic Overdose , Sympathomimetic Adverse Reaction II. Causes: Illicit s ( or , ) s ( ) III. Symptoms Anxiety Euphoria Increased alertness Increased vigilance IV. Associated Conditions V. Signs (Mnemonic: Aspirin) Sweaty Pulmonary edema Irritability Ringing in the ears Increased or VI. Signs: Systemic Sympathomimetic Effect Cardiovascular Arrhythmia Widened QRS wave duration Asymptomatic Cerebral bleeding Risk from

2018 FP Notebook

5. Toxic ingestions in children

with resultant toxicity or risk of toxicity. Agents consumed may be pharmaceutical substances; drugs of abuse (including alcohol); toxic plants, berries, or mushrooms; or chemicals. History and exam medication error in infants witnessed ingestion or child found with empty bottle or pill hx of deliberate ingestion hx of substance abuse sympathomimetic toxidrome antimuscarinic toxidrome opioid toxidrome sedative-hypnotic toxidrome cholinergic toxidrome nausea, vomiting, or diarrhoea altered mental status fever (...) Toxic ingestions in children Toxic ingestions in children - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Toxic ingestions in children Last reviewed: February 2019 Last updated: March 2018 Summary Children may ingest a toxic substance accidentally while exploring their environment, or deliberately in response to stress or underlying mental problems, or in an attempt to get 'high'. A regional poison-control centre

2018 BMJ Best Practice

6. Toxicity, Sympathomimetic (Follow-up)

Toxicity, Sympathomimetic (Follow-up) Sympathomimetic Toxicity Treatment & Management: Approach Considerations, Emergency Department Care, Synthetic cathinones Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache (...) =aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvODE4NTgzLXRyZWF0bWVudA== processing > Sympathomimetic Toxicity Treatment & Management Updated: Jul 17, 2018 Author: Paul Kolecki, MD, FACEP; Chief Editor: Asim Tarabar, MD Share Email Print Feedback Close Sections Sections Sympathomimetic Toxicity Treatment Approach Considerations Managing the airway and controlling agitation are the two main prehospital treatment concerns. Many patients with sympathomimetic poisoning present in an agitated state and may require physical and/or chemical restraint. A rapid bedside

2014 eMedicine Emergency Medicine

7. Toxicity, Sympathomimetic (Diagnosis)

Toxicity, Sympathomimetic (Diagnosis) Sympathomimetic Toxicity: Practice Essentials, Pathophysiology, Etiology Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvODE4NTgzLW92ZXJ2aWV3 processing > Sympathomimetic (...) Toxicity Updated: Jul 17, 2018 Author: Paul Kolecki, MD, FACEP; Chief Editor: Asim Tarabar, MD Share Email Print Feedback Close Sections Sections Sympathomimetic Toxicity Overview Practice Essentials Poisoning from sympathomimetic agents occurs with both prescription and nonprescription drugs. Prescription sympathomimetic agents are in common use, especially for treating diseases such as asthma and narcolepsy. Examples of nonprescription sympathomimetic agents include the over-the-counter cold

2014 eMedicine Emergency Medicine

8. Toxicity, Sympathomimetic (Treatment)

Toxicity, Sympathomimetic (Treatment) Sympathomimetic Toxicity Treatment & Management: Approach Considerations, Emergency Department Care, Synthetic cathinones Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache (...) =aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvODE4NTgzLXRyZWF0bWVudA== processing > Sympathomimetic Toxicity Treatment & Management Updated: Jul 17, 2018 Author: Paul Kolecki, MD, FACEP; Chief Editor: Asim Tarabar, MD Share Email Print Feedback Close Sections Sections Sympathomimetic Toxicity Treatment Approach Considerations Managing the airway and controlling agitation are the two main prehospital treatment concerns. Many patients with sympathomimetic poisoning present in an agitated state and may require physical and/or chemical restraint. A rapid bedside

2014 eMedicine Emergency Medicine

9. Toxicity, Sympathomimetic (Overview)

Toxicity, Sympathomimetic (Overview) Sympathomimetic Toxicity: Practice Essentials, Pathophysiology, Etiology Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvODE4NTgzLW92ZXJ2aWV3 processing > Sympathomimetic (...) Toxicity Updated: Jul 17, 2018 Author: Paul Kolecki, MD, FACEP; Chief Editor: Asim Tarabar, MD Share Email Print Feedback Close Sections Sections Sympathomimetic Toxicity Overview Practice Essentials Poisoning from sympathomimetic agents occurs with both prescription and nonprescription drugs. Prescription sympathomimetic agents are in common use, especially for treating diseases such as asthma and narcolepsy. Examples of nonprescription sympathomimetic agents include the over-the-counter cold

2014 eMedicine Emergency Medicine

10. An Infant with a Prolonged Sympathomimetic Toxidrome after Lisdexamfetamine Dimesylate Ingestion (PubMed)

An Infant with a Prolonged Sympathomimetic Toxidrome after Lisdexamfetamine Dimesylate Ingestion Stimulant medications are approved to treat attention deficit hyperactivity disorder (ADHD) in children over the age of 6 years. Fatal ingestion of stimulants by children has been reported, although most ingestions do not result in severe toxicity. Lisdexamfetamine dimesylate, a once daily long-acting stimulant, is a prodrug requiring conversion to its active form, dextroamphetamine (...) of symptoms.Amphetamine ingestions in young children are uncommon but do occur. Clinicians should be aware of signs and symptoms of amphetamine toxicity and consider ingestion when a pediatric patient presents with symptoms of a sympathetic toxidrome even when ingestion is denied.

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2016 Journal of Medical Toxicology

11. Sympathomimetic Toxicity

Sympathomimetic Toxicity Sympathomimetic Toxicity Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Sympathomimetic Toxicity (...) Sympathomimetic Toxicity Aka: Sympathomimetic Toxicity , Adrenergic Overdose , Sympathomimetic Overdose , Sympathomimetic Adverse Reaction II. Causes: Illicit s ( or , ) s ( ) III. Symptoms Anxiety Euphoria Increased alertness Increased vigilance IV. Associated Conditions V. Signs (Mnemonic: Aspirin) Sweaty Pulmonary edema Irritability Ringing in the ears Increased or VI. Signs: Systemic Sympathomimetic Effect Cardiovascular Arrhythmia Widened QRS wave duration Asymptomatic Cerebral bleeding Risk from

2015 FP Notebook

12. Comprehensive review of cardiovascular toxicity of drugs and related agents (PubMed)

effects on the heart, blood vessels, or both. The mechanism(s) of toxic action are discussed and treatment modalities are briefly mentioned in relevant cases. Due to the large number of clinically relevant compounds discussed, this article could be of interest to a broad audience including pharmacologists and toxicologists, pharmacists, physicians, and medicinal chemists. Particular emphasis is given to clinically relevant topics including the cardiovascular toxicity of illicit sympathomimetic drugs (...) Comprehensive review of cardiovascular toxicity of drugs and related agents Cardiovascular diseases are a leading cause of morbidity and mortality in most developed countries of the world. Pharmaceuticals, illicit drugs, and toxins can significantly contribute to the overall cardiovascular burden and thus deserve attention. The present article is a systematic overview of drugs that may induce distinct cardiovascular toxicity. The compounds are classified into agents that have significant

Full Text available with Trip Pro

2018 Medicinal research reviews

13. Presentations to an urban emergency department in Bern, Switzerland associated with acute recreational drug toxicity. (PubMed)

, three acute myocardial infarctions, two intracranial haemorrhages, as well as psychosis and seizures in 71 and 26 cases, respectively.Most medical problems related to recreational drug use were associated with cocaine and cannabis use and were mainly characterised by central nervous system depression, sympathomimetic toxicity and/or psychiatric disorders. Presentations related to acute toxicities of NPSs appear to be uncommon, while prescription drugs were after classical recreational drugs (...) Presentations to an urban emergency department in Bern, Switzerland associated with acute recreational drug toxicity. Although the recreational use of psychoactive substances is common there is only limited systematic collection of data on acute drug toxicity or hospital presentations. Currently, data from Switzerland are only available from the University Hospital of Basel. The present study aimed to describe the presentations due to recreational drug use at an emergency department in Bern

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2017 Scandinavian journal of trauma, resuscitation and emergency medicine

14. Presentations due to acute toxicity of psychoactive substances in an urban emergency department in Switzerland: a case series (PubMed)

 %), anxiety (23 %), nausea or vomiting (18 %), and agitation (17 %). Severe complications included two fatalities, two acute myocardial infarctions, seizures (13 cases), and psychosis (six cases). Most patients (76 %) were discharged home, 10 % were admitted to intensive care, and 2 % were referred to psychiatric care.Most medical problems related to illicit drugs concerned cocaine and cannabis and mainly included sympathomimetic toxicity and/or psychiatric disorders confirming data from the prior year (...) Presentations due to acute toxicity of psychoactive substances in an urban emergency department in Switzerland: a case series Although the recreational use of psychoactive substances is common there is only limited systematic collection of data on acute drug toxicity or hospital presentations, in particular regarding novel psychoactive substances (NPS) that have emerged on the illicit market in the last years.We included all cases presenting at the emergency department (ED) of the University

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2016 BMC pharmacology & toxicology

15. Arterial Necrosis Caused by Methoxamine: A Comparison Between Acute Experimental Hypertensive Arterial Disease in the Rat and Lesions Caused by A Sympathomimetic Amine (PubMed)

Br J Exp Pathol 0372543 0007-1021 0 Sympathomimetics HUQ1KC1YLI Methoxamine OM Animals Hypertension Methoxamine Necrosis Rats Sympathomimetics toxicity Vascular Diseases HYPERTENSION/experimental NECROSIS/experimental SYMPATHOMIMETICS/toxicology 1962 4 1 1962 4 1 0 1 1962 4 1 0 0 ppublish 13896893 PMC2094674 Proc Soc Exp Biol Med. 1955 Nov;90(2):342-6 13273443 Am J Pathol. 1958 Sep-Oct;34(5):817-33 13571375 J Pathol Bacteriol. 1959 Apr;77(2):597-603 13642206 (...) Arterial Necrosis Caused by Methoxamine: A Comparison Between Acute Experimental Hypertensive Arterial Disease in the Rat and Lesions Caused by A Sympathomimetic Amine 13896893 1998 11 01 2018 12 01 0007-1021 43 1962 Apr British journal of experimental pathology Br J Exp Pathol Arterial necrosis caused by methoxamine: a comparison between acute experimental hypertensive arterial disease in the rat and lesions caused by a sympathomimetic amine. 213-20 GARDNER D L DL eng Journal Article England

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1962 British journal of experimental pathology

16. Serious toxicity and fatalities from synthetic cannabinoids

Serious toxicity and fatalities from synthetic cannabinoids Serious toxicity and fatalities from synthetic cannabinoids » The Poison Review Serious toxicity and fatalities from synthetic cannabinoids July 20, 2015, 1:44 pm Synthetic Cannabinoid—Related Illnesses and Deaths. Trecki J et al. N Engl J Med 2015 Jul 9;373:103-107. As the authors point out in this interesting article, there has been a recent surge in reports of fatalities and severe toxicity from (SCs). This is likely from (...) a combination of increased incidence and more diligent surveillance. The most interesting part of the paper is the Table, that lists recent cases involving severe toxic effects from SCs, including 20 deaths. The specific SCs involved in the fatal cases include , , , , and . the authors also highlight the difficulties involved in dealing with these new agents, especially the time required to develop specific laboratory tests and the rapidly changing mix of chemicals being marketed as SCs. Worth reading

2015 The Poison Review blog

17. Clenbuterol toxicity: a NSW Poisons Information Centre experience. (PubMed)

Clenbuterol toxicity: a NSW Poisons Information Centre experience. To describe the epidemiology and toxicity of clenbuterol in exposures reported to the NSW Poisons Information Centre (NSWPIC).Retrospective observational study analysing data from all calls about clenbuterol exposure recorded in the NSWPIC database from 1 January 2004 to 31 December 2012. The NSWPIC coversthe Australian jurisdictions New South Wales, Tasmania and the Australian Capital Territory 24 hours a day and provides after (...) products who present with protracted sympathomimetic features. The potential for misuse of this substance requires reconsideration of its current poison schedule registration and its availability.

2014 Medical Journal of Australia

18. Toxicity, Phencyclidine (Overview)

Toxicity, Phencyclidine (Overview) Phencyclidine Toxicity: Practice Essentials, Background, Pathophysiology Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvODE2MzQ4LW92ZXJ2aWV3 processing > Phencyclidine Toxicity (...) Updated: Feb 13, 2019 Author: Patrick L West, MD; Chief Editor: Michael A Miller, MD Share Email Print Feedback Close Sections Sections Phencyclidine Toxicity Overview Practice Essentials Phencyclidine (PCP) is a hallucinogen—specifically, a dissociative anesthetic—that can produce a wide variety of physical and behavioral effects and has a high potential for abuse and dependence. Acute toxicity often resembling a psychotic episode. PCP is often taken in conjunction with other co-ingestants, including

2014 eMedicine.com

19. Toxicity, Cocaine (Overview)

Toxicity, Cocaine (Overview) Cocaine Toxicity: Practice Essentials, Background, Pathophysiology Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvODEzOTU5LW92ZXJ2aWV3 processing > Cocaine Toxicity Updated: Sep 01 (...) , 2018 Author: Lynn Barkley Burnett, MD, EdD, LLB(c); Chief Editor: Sage W Wiener, MD Share Email Print Feedback Close Sections Sections Cocaine Toxicity Overview Practice Essentials Despite being overshadowed by opioids in recent years, cocaine remains one of the most common causes of drug-related emergency department (ED) visits in the United States. [ ] Although nearly every organ system can be affected by cocaine toxicity, most patients present with cardiovascular complaints. [ ] In addition

2014 eMedicine.com

20. Toxicity, Cocaine (Treatment)

Toxicity, Cocaine (Treatment) Cocaine Toxicity Treatment & Management: Prehospital Care, Emergency Department Care, Therapeutic Dilemmas Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvODEzOTU5LXRyZWF0bWVudA (...) == processing > Cocaine Toxicity Treatment & Management Updated: Sep 01, 2018 Author: Lynn Barkley Burnett, MD, EdD, LLB(c); Chief Editor: Sage W Wiener, MD Share Email Print Feedback Close Sections Sections Cocaine Toxicity Treatment Prehospital Care Prehospital care includes the following: Assess the patient's airway, breathing, and circulation (ABCs); intervene if necessary Provide oxygen Obtain intravenous access Closely monitor vital signs, including temperature Monitor glucose levels for patients

2014 eMedicine.com

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