After identification of the sympathomimetic toxidrome, emergent care involves rapid sedation, hemodynamic stabilization, and active cooling for those with hyperthermia.
Diagnosis Overview:
The sympathomimetic toxidrome is a combination of vital sign abnormalities and physical examination findings that are characteristic of an overdose with certain classes of xenobiotics, most commonly cocaine and amphetamines. Signs of sympathomimetic toxicity are reflective of the overactivity of the sympathetic nervous system and include hyperthermia, tachycardia, hypertension, agitation and delirium, diaphoresis, tremor, and seizures.
Other sources include:
- Naturally occurring versions of the khat plant (Catha edulis, which has been chewed for centuries due to its amphetamine-like effect).
- Synthetic cathinones (known as "bath salts" in America and as "plant food" in Europe).
- Tyramine-rich foods (eg, aged cheese, red wine, and other fermented products) in combination with certain medications that act as monoamine oxidase (MOA) inhibitors.
- This toxidrome can also manifest after the overuse of certain pharmaceuticals, including Adderall (amphetamine salts), Ritalin (methylphenidate), and Wellbutrin (bupropion).
Related topics: cocaine intoxication and use disorder, cocaine-related cardiomyopathy, methamphetamine use disorder
