The toxins that lead to the sympathomimetic toxidromeare uncommon poisonings but have specific treatments and correct diagnosis is important.

• Theophylline
• Beta 2 agonists (salbutamol & terbutaline)
• Chloral hydrate
• MAO inhibitors
• Amphetamines
• Cocaine
• Alcohol and barbiturate withdrawal also causes an adrenergic syndrome

Other drugs that cause seizures or agitation may mimic the adrenergic syndrome but these will not be discussed here.

Features that help to differentiate between these drugs are:

• PUPIL SIZE & REACTION
• LEVEL OF CONSCIOUSNESS
• ECG CHANGES
• RESPONSE TO ANTAGONISTS
• ELECTROLYTES/BLOOD GLUCOSE
• BLOOD CONCENTRATIONS