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Drug Enforcement Agency: Drug info

Clin Med (CME Poisons)

Epidemiology and Clin Presentation:

Common features in acute poisoning:

miosis: Opioids, organophosphorus insecticides, nerve agents

mydriasis: TCA, amfetamines, cocaine, anticholinergic drugs

blindness: methanol, quinine

papilloedema: CO, methanol

convulsions: TCA, theophylline, opioids, mefenamic acid, isoniazid, amfetamines

dystonic reactions: metoclopramide, phenothiazines

divergent nystagmus: TCA

nystagmus: phenytoin, carbamazepine

hypertonia & hyperreflexia: TCA, other anticholinergic drugs

hyperventilation: salicylates, phenoxyacetate herbicides, theophylline

hyperthermia: ecstacy (MDMA)

blisters: usually occur in comatose patient

Common feature clusters in acute poisoning

coma, hypertonia, hyperreflexia, extensor plantar responses, myoclonus, strabismus, mydriasis, sinus tachycardia: TCA (less commonly antihistamines, orphenadrine, thioridazine)

coma, hypotonia, hyporeflexia, flexor or non-elicitable plantar responses, hypotension: barbiturates, BDA and alcohol, TCA

coma, miosis, dcrd RR: opioids

N&V, tinnitus, deafness, swe


Ix and Mx of the poisoned pt, Toxins with cardiovasc effects, Analgesics

Acute Poisoning,