0071643192.pdf

TOXICOLOGY

DIFFERENTIAL DIAGNOSIS BY CHIEF COMPLAINT

Although the poisoned patient may present with varied symptoms and com-

plaints, the chief presenting complaint or symptom may suggest a diagnosis

(see Table 6.1).

TOXIDROMES

Recognition of grouped symptoms and findings consistent with a tox-

idrome (see Table 6.2) can guide diagnosis and treatment in the poisoned

patient.

TABLE 6.1. Primary Considerations for Presenting Chief Complaint in the Poisoned Patient

CHIEFCOMPLAINT COMMONCAUSES

Coma Alcohols

Antipsychotics

Antiseizure medications

Carbon monoxide

Muscle relaxants

Opiates

Sedative/hypnotics

Delirium Anticholinergics/cholinergics

Muscle relaxants

Sympathomimetics

Withdrawal syndromes

Seizure Isonaizid

Anticholinergics/cholinergics

Antidepressants

Mushrooms (Gyrometrasp.)

Sympathomimetics

Toxic alcohols

Withdrawal syndromes

Hepatic injury Acetaminophen

Carbon tetrachloride

Ethanol

Mushrooms(Amanita phalloides)

Renal injury Ethylene glycol

Heavy metal salts (mercury)

Mushrooms (Cortinarius orellanus)

Rhabdomyolysis (cocaine, amphetamines)