ContentsSynopsisCodesLook ForDiagnostic PearlsDifferential Diagnosis & PitfallsBest TestsManagement PearlsTherapyDrug Reaction DataReferences
Potentially life-threatening emergency
Sympathomimetic toxicity
Print
Other Resources UpToDate PubMed
Potentially life-threatening emergency

Sympathomimetic toxicity

Print Images (1)
Contributors: Shanna Yang, Benjamin L. Mazer MD, MBA, Abhijeet Waghray MD
Other Resources UpToDate PubMed

Synopsis

The sympathomimetic toxidrome is a combination of physical findings characteristic of overdose of certain classes of drugs, including cocaine and amphetamines. Other sources include naturally occurring versions of the khat plant (Catha edulis, which has been chewed for centuries due to its amphetamine-like effect), from which synthetic cathinones (known as "bath salts" in America and as "plant food" in Europe) are derived. Ingestion of tyramine-rich foods (eg, aged cheese, red wine, and other fermented products) in combination with certain medications that act as monoamine oxidase (MOA) inhibitors can also produce this effect. Signs of sympathomimetic toxicity are suggestive of overactivity of the sympathetic nervous system.

Sympathomimetic agents mimic the effects of catecholamines (eg, epinephrine, norepinephrine, dopamine), causing increased sympathetic activity in the nervous system. They are separated into direct sympathomimetics (eg, epinephrine, phenylephrine), which bind directly to an adrenergic receptor; indirect sympathomimetics (eg, amphetamine, tyramine), which enhance the activity of catecholamines; and mixed (eg, ephedrine), which have both direct and indirect properties. Direct sympathomimetics are further separated based on their selectivity for a receptor (eg, α1 receptor for phenylephrine) or lack of selectivity (eg, nonselective adrenergic receptor agents).

Related topic: Cocaine-related cardiomyopathy

Codes

ICD10CM:
T44.901A – Poisoning by unspecified drugs primarily affecting the autonomic nervous system, accidental (unintentional), initial encounter

SNOMEDCT:
45536007 – Poisoning by sympathomimetic drug

Look For

Subscription Required

Diagnostic Pearls

Subscription Required

Differential Diagnosis & Pitfalls

Best Tests

Subscription Required

Management Pearls

Subscription Required

Therapy

Subscription Required

Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

Subscription Required

References

Subscription Required

Last Reviewed: 10/10/2019
Last Updated: 11/01/2019
Copyright © 2020 VisualDx®. All rights reserved.
Potentially life-threatening emergency
Sympathomimetic toxicity
Print 1 Images
Sympathomimetic toxicity : Agitation, Chemical substance abuse, Tachycardia, Cardiac dysrhythmia, Diaphoresis, Hypertension, Mydriasis, Tremor, Hyperthermia
Copyright © 2020 VisualDx®. All rights reserved.