Hyperthermic Toxidromes Five toxidromes may present with overlapping features: hyperthermia, rhabdomyolysis, altered mental status/seizures. • Sympathomimetic - Excess release of monoamines (epi, NE, DA, 5HT) leading to overstimulation of adrenergic receptors. • Anticholinergic - Blockade of muscarinic Ach receptors impairs acetylcholine signaling in the CNS, on cardiac & smooth muscle, and on sweat glands. • Serotonin Syndrome - Excessive release of 5HT, usually due to combination of 2 or more serotoninergic meds. Rarely it can occur with a single serotonergic agent. • Neuroleptic Malignant - Ideosyncratic reaction to dopamine blockers (e.g. anti-psychotic) or due to abrupt cessation of dopamine agonists (e.g. Parkinson’s Tx) • Malignant Hyperthermia - Rare pharmacogenetic disease caused by genetic susceptibility (AD mutations in ryanodine receptor) & triggered by inhaled anesthetics by Nick Mark MD @nickmmark #Hyperthermic #Toxidromes #comparison #table #diagnosis #differential #toxicology
