Anticholinergic toxidrome

Classic features ("hot as a hare, dry as a bone, red as a beet, blind as a bat, mad as a hatter"): • Hyperthermia, dry skin/mucosae, flushed skin • Mydriasis, blurred vision (loss of accommodation) • Delirium, agitation, picking behaviour, hallucinations • Tachycardia, urinary retention, ileus Common causes: TCAs (ALSO Na⁺-channel toxicity — manage as TCA pathway), antihistamines (chlorphenamine, diphenhydramine, cyclizine), antipsychotics, atropine/hyoscine, antimuscarinics for OAB, plant alkaloids (Datura, Atropa). ABCDE; continuous monitoring, IV access; bloods inc. paracetamol/salicylate, CK (rhabdo), ECG.