• History – patient relative
• Agent
• Dose
• Time of ingestion

Examination

• Vital signs
• Neurological – tone, clonus, reactive pupils
• Abdomen – bowel sounds
• Skin changes
• Urinary retention
• Clinical syndromes

Anticholinergic syndrome

• Delirium with mumbling speech, tachycardia, dry, flushed skin,

Cholinergic syndrome

• Muscurinic effect – diarrhoea, urination, miosis, bronchospasm, emesis
• Nicotinic effect – mydriasis, tachycardia, weankess, hypertension, fasciculation, sweating
• CNS effect – drowsy, delirium, confusion, coma, seizure

Sympathomimetics Syndrome

• Causes amphetamine, ecstacy

Delusions, paranoia, tachycardia, tachypnoiec, pyrexia, piloerection

Cold and clammy with low saturation

Catecholamine induced cardiomyopathy

Chest X-ray pulmonary oedema

Opioid, sedatives or ethanol intoxication