In this post I link to Drs. Faidal and Farkas’ summary graphics on toxidromes.
Here is Dr. Faidal’s (of ddx.com) summary graphic on toxidromes from Toxidromes
posted in Toxicology on September 21, 2020.
Click here to be taken to a clearer and larger example of the above flow chart.
Diagnostic Tests
ALL PATIENTS MOST PATIENTS CRITICAL PATIENTS POC glucose Core temperature
ECG
Urine hCG
BMP UA
Acetaminophen
Salicylate
Ethanol
LFT Lipase
Serum osmolarity
Ionized calcium
Magnesium
GI Decontamination
Activated charcoal
Activated charcoal (1g/kg) within 1-hour post-ingestion and if the patient is awake and cooperative (or via enteric tube if intubated).
Not recommended
- Heavy metals
- Ions (ex. lithium)
- Corrosives
- Hydrocarbons
- Alcohols
Whole-bowel irrigation
Indicated for sustained-release formulations, expulsion of body packing materials, or ingestion of agent not absorbed by activated charcoal.
Gap-producing Toxidromes
Osmolar Gap
- Toxic alcohol
- Ethanol
- Methanol
- Ethylene glycol
- Isopropyl alcohol
- Drug stabilizing agents
- Mannitol
- Propylene glycol
- Glycerol
Anion Gap
- Salicylate
- Iron
- Isoniazid
- Methanol
- Ethylene glycol
- Cyanide
And now, from Dr. Farkas’ Internet Book of Critical Care [link is to the Table of Contents] Chapter, Serotonin Syndrome, June 13, 2019; here is the summary toxidrome table:
