Case 1

An 18 year old female is brought in to the Emergency Department at 8pm following a deliberate self-poisoning. She was found by her parents with multiple empty medication packets around her. She had been perfectly well this morning. The patient is hyper-aroused but confused, and is unable to tell you what tablets she has taken. Her parents tell you she has a background history of depression, for which she has been prescribed medication.

From the end of the bed, you can see she is agitated and fidgeting, looking around the room anxiously.  She is disorientated to time and place. She is warm and sweaty to touch. Her obs are as follows;

• HR 120

• BP 150/90

• SpO2 98% on RA

• RR 22

• Temp 37.7

Question 1

What toxidrome is this patient most likely to be suffering from?

Question 2

What medications can be responsible for this condition?

Question 3

What would you expect to find on neurological exam?

Question 4

What is the treatment of this condition?