Toxic agent |
Features which may distinguish from opioids |
Antihistamines |
Anticholinergic toxidrome |
Antipsychotics |
Pupils, bowel sounds normal |
Barbiturates |
Mild to severe hypotension, serum concentration |
β-adrenergic antagonists |
Cardiovascular findings (hypotension, bradycardia) more prominent than mental status findings |
Calcium channel blockers |
Cardiovascular findings (hypotension, bradycardia, or tachycardia) more prominent than mental status findings |
Carbamazepine |
Serum concentration |
Carbon monoxide |
Carboxyhemoglobin level |
Clonidine |
Bradycardia, hypotension |
Cyclic antidepressants |
QRS prolongation, hypotension, tachycardia |
Ethanol |
Pupils, bowel sounds normal, serum concentration |
Ethylene glycol |
Pupils, bowel sounds normal |
Hypoglycemic agents |
Serum glucose concentration |
Isoniazid |
History of seizures, normal pupils, bowel sounds |
Isopropanol |
Pupils, bowel sounds normal |
Lithium |
Tremor, hyperreflexia, serum concentration |
Methanol |
Pupils, bowel sounds normal |
Organic-phosphorous compounds |
Cholinergic toxidrome |
Phencyclidine |
Nystagmus (horizontal, vertical, or rotary) |
Sedative-hypnotic agents |
Pupil size normal to decreased, bowel sounds normal, less respiratory depression |