All right, so welcome back to the Internet Book of Critical Care Podcast.

I'm here with Adam Thomas, and we're going to talk about sympathetic intoxication.

Let's make up for lost time and get into a fun topic that we all enjoy, right?

Yeah, and just to reassure all of our listeners, we are going to get to all the topics eventually. Life is complicated and we may not get to them all immediately. But we're

going to get there and it'll take some time. Josh is just being nice. He's saying he's far more

efficient than I am and he's waiting for me to pick up the slack. We're working on it.

Okay, Josh, let's get into this because this is a lot of fun. So some pathomimetic overdose.

We've seen this.

They're hopped up.

They're going berserk.

There's a spectrum of just agitation to excited delirium.

But let's talk about evaluation, management, and some specifics around both the drugs they

took and the drugs we give them.

So start me off.

What is a

sympathymomatic and why is it okay to just throw all these together?

Yeah, so there are a lot of different ones. This includes cocaine, methamphetamine, aka

crystal meth, medical amphetamines. There are all sorts of, do you know that physicians

in the United States at least technically can prescribe methamphetamine. That's a fun fact I was not aware of. But there's all sorts of other amphetamines that are used therapeutically for attention deficit disorder. And then,

of course, we have MDMA or ecstasy and the new ones on the block, synthetic caffeinones or baths

salt. So there's this wide variety of these things. But I think clinically they're going to look

pretty similar. And unless you're some sort of like super guru and intoxication, you can basically

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