Potentially life-threatening emergency
Sympathomimetic toxicity
Alerts and Notices
Synopsis

Sympathomimetic agents mimic the effects of catecholamines (eg, epinephrine, norepinephrine, dopamine), causing increased sympathetic activity in the nervous system. They are separated into direct sympathomimetics (eg, epinephrine, phenylephrine), which bind directly to an adrenergic receptor; indirect sympathomimetics (eg, amphetamine, tyramine), which enhance the activity of catecholamines; and mixed (eg, ephedrine), which have both direct and indirect properties. Direct sympathomimetics are further separated based on their selectivity for a receptor (eg, α1 receptor for phenylephrine) or lack of selectivity (eg, nonselective adrenergic receptor agents).
Related topic: Cocaine-related cardiomyopathy
Codes
ICD10CM:T44.901A – Poisoning by unspecified drugs primarily affecting the autonomic nervous system, accidental (unintentional), initial encounter
SNOMEDCT:
45536007 – Poisoning by sympathomimetic drug
Look For
Subscription Required
Diagnostic Pearls
Subscription Required
Differential Diagnosis & Pitfalls
- Alcohol withdrawal
- Cholinergic toxicity
- Anticholinergic toxicity
- Serotonin syndrome
- Drug side effects (eg, amphetamines [prescribed or recreational], ephedrine, salicylates)
- Psychiatric disorder
- Influenza
- Hypoglycemia
- Diabetic ketoacidosis
- Hyperthyroidism / thyrotoxicosis
- Electrolyte disturbance (eg, hypomagnesemia, hypophosphatemia)
- Neuroleptic malignant syndrome
Best Tests
Subscription Required
Management Pearls
Subscription Required
Therapy
Subscription Required
Drug Reaction Data
Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.Subscription Required
References
Subscription Required
Last Reviewed:10/09/2019
Last Updated:10/31/2019
Last Updated:10/31/2019