Toxidrome	Mental status	Vital signs	Eyes	Lungs	Bowel sounds	Neurologic	Dermatologic
Antimuscarinic, commonly referred to as anticholinergic (e.g., dicyclomine, diphenhydramine, oxybutynin, scopolamine)	Agitation, hallucinations including formication, hyperactive delirium	↑ BP ↑ HR ↑ T	Mydriasis	Normal	Decreased	Ataxia	Hot and dry
Cholinergic (e.g., donepezil [Aricept], galantamine [Razadyne], pyridostigmine [Mestinon])	Normal	↑ or ↓ BP ↑ or ↓ HR ↑ or ↓ RR	Myosis, mydriasis	Bronchorrhea	Increased	Fasciculations, weakness	Diaphoretic
Opioid (e.g., codeine, fentanyl, hydromorphone [Dilaudid], oxycodone)	Central nervous system depression, coma in severe cases, stupor	↓ BP ↓ HR ↓ RR	Miosis	Respiratory depression: bradypnea, hypopnea	Decreased	Decreased pain, diminished reflexes	May see cold, clammy skin and cyanosis
Opioid withdrawal	Dysphoric	↑ HR	Mydriasis	Normal	Increased	Nonfocal hyperreflexia, yawning	Piloerection diaphoresis
Sedative hypnotics (e.g., alprazolam, clonazepam, lorazepam)	Anterograde amnesia, central nervous system depression, cognitive impairment, coma in severe cases, stupor	Typically normal, may have ↓ BP	Nystagmus	Respiratory depression: bradypnea, hypopnea in severe cases	Normal	Slurred speech, ataxia	Normal
Serotonin syndrome	Agitation, hyperactive delirium	↑ BP ↑ HR ↑ RR ↑ T	Ocular clonus	Normal	Normal or increased	Hyperreflexia, clonus	Diaphoretic
Sympathomimetic	Agitated, hyperactive delirium, pressured speech	↑ BP ↑ HR ↑ RR ↑ T	Mydriasis	Normal	Normal or increased	Nonfocal hyperreflexia	Diaphoretic