Poisonings (Intoxications): Symptoms, Complaints, Signs

The following symptoms and complaints may indicate intoxications (poisonings):

  • Disturbances of consciousness up to unconsciousness
  • Neurological disorders such as:
    • Seizures
    • Pupillary disturbances
    • Hallucinations
    • Extrapyramidal disorders (disturbances in the course of movement).
  • Cardiopulmonary (“affecting the heart and lungs”) disorders such as:
    • Respiratory disorders up to respiratory arrest
    • Cardiovascular disorders up to cardiac arrest
    • Cardiac arrhythmias, unspecified
    • Pulmonary edema (accumulation of fluid in the lung tissue or alveoli)
    • Shock
  • Foetor ex ore (bad breath)
  • Nausea (nausea)/vomiting
  • Diarrhea (diarrhea), constipation (constipation).
  • Abdominal pain
  • Cephalgia (headache)
  • Vertigo (dizziness)
  • Renal dysfunction, unspecified
  • Changes in skin coloration (skin color) such as rosy or gray skin.

Poisoning can manifest itself through a variety of different symptoms.

Toxidromes of substances or classes of substances

Toxidrome BD Pulse Temp AF Pupil Behavior Skin Leading symptoms Toxins (examples)
Anticholinergic syndrome ↑ ↑ ↓* Mydriasis (wide) Agitated hot and dry Dry mouth, constipation (constipation), urinary retention, intestinal paralysis (bowel paralysis), ventricular tachycardia (heartbeat too fast: > 100 beats per minute), tremor (shaking), seizure, hallucination, coma Antidepressants* (tricyclics), 1st-generation antihistamines (e.g., diphenhydramine), atropine, Atropa belladonna (deadly nightshade), antipsychotics (neuroleptics), bisperides, scopolamine,
Cholinergic syndrome ↕ ↓ ↕ ↑ Miosis (eng) Anxious, restless, vigilance reduction(reduction of alertness). Humid Accommodative dysfunction, diarrhea (diarrhea), sweating, salivation (salivation), and rhinorrhea (lacrimation) Alkyl phosphates (E605), carbamates (insecticide), cholinergics, cholinesterase inhibitors (some), methyl carbamates, physostigmine, muscarinic mushrooms (funnel mushrooms: Clitocybe, crack mushrooms: (Inocybe))
Epileptogenic syndrome ↑ ↑ ↔ ↑ Hyperreflexia, tremor (shaking). Ethanol (ethanol; alcohol), ethylene glycol, cocaine.
Hallucinogenic syndrome ↑ ↑ ↑ ↕ mostly wide hallucinatingDelirant warm acute psychosis, nystagmus (involuntary rhythmic movement of the eye) Amphetamines,z.B. Ectasy (synonym: molly; MDMA: 3,4-methylenedioxy-N-methylamphetamine); THC (tetrahydro-cannabinol, cannabinoids), LSD, mescaline, psilocybin-containing mushrooms.
Malignant neuroleptic syndrome. ↓ ↓ ↑ ↑ Accommodation disorders fluctuating state of consciousness autonomic instability, rigidity, catalepsy (prolonged persistence in partially bizarre posture) Neuroleptics (especially typical and atypical neuroleptics).
Opioid syndrome ↓ ↓ ↓ ↓ Miosis Respiratory failure (weakness in breathing), pulmonary edema (water retention in the lungs), impaired consciousness; decreased intestinal motility Opiates (morphine, heroin, and many others ), fentanyl, methadone, synthetic opioids.
Sedating-narcotic syndrome ↓ ↓ ↓ ↓ Mostly narrow Vigilance reduction Respiratory insufficiency (immune deficiency), hyporeflexia (decreased reflexes), stupor (rigidity of the whole body while conscious), coma Ethanol (ethanol; alcohol), antihistamines barbiturates, benzodiazepines, MDMA, opiates, opioids
Serotonin syndrome ↑ ↑ ↑ ↑ agitated, confused, aggressiveness Autonomic instability, sweating, convulsions, myoclonias (shaking spasms), tremor (shaking) MAO inhibitors, SRRI (selective serotonin reuptake inhibitor))Usually complication of combination of two serotonergic the drugs or intoxication.
Sympatho-mimetic syndrome ↑ ↑ ↑ ↑ Mydriasis (wide) Agitated, restless hot and humid Hyperreflexia, headache, tachyarrhythmias. Amphetamines, ecstasy, ephedrine, cocaine, MAO inhibitors, MDMA

Legend: AF (= respiratory rate), BD (= blood pressure), temperature (= body temperature).

Carbon monoxide poisoning

The following symptoms and complaints may indicate carbon monoxide poisoning:

  • Cephalgia (headache)
  • Vertigo (dizziness)
  • Pectanginal discomfort (chest pain).
  • Loss of orientation
  • Faintness
  • Death

Note: The much-cited “cherry red” skin color of poisoning victims is rarely observed in practice.

Poison control centers in German-speaking countries

Location Emergency phone number
Berlin 030 – 19240
Bonn 0228 -19240
Erfurt 0361 – 730730
Freiburg 0761 – 19240
Göttingen 0551 – 383180
Homburg/Saar 06841 – 19240
Mainz 0631 – 19249
Munich 089 – 19240
Nuremberg 0911 – 389-2451
Vienna 0043 – 1 – 4064343
Zurich 0041 – 44 – 2515151