Sympathomimetic drugs

The spectrum and severity of a sympathomimetic toxidrome depends on whether the causative drug has predominantly adrenergic, dopaminergic or serotonergic effects. Causative drugs include:

• medications
  • beta-adrenergic receptor agonists (eg salbutamol)
  • catecholamines (eg adrenaline [epinephrine], dopamine, isoprenaline, noradrenaline [norepinephrine], phenylephrine)
  • indirect sympathomimetics (eg dexamfetamine, lisdexamfetamine, methylphenidate, phentermine, pseudoephedrine)
  • nonamfetamine psychostimulants (eg armodafinil, modafinil)
  • monoamine oxidase inhibitors (MAOIs) (eg phenelzine, tranylcypromine)
  • serotonin and noradrenaline reuptake inhibitors (SNRIs) (atomoxetine, desvenlafaxine, duloxetine, reboxetine, venlafaxine)
  • xanthines (eg theophylline and caffeine).
• illicit stimulants
  • amfetamines and their derivatives (eg metamfetamine [methamphetamine], methylenedioxymetamfetamine [methylenedioxymethamphetamine, MDMA or ‘ecstasy’]) (see Stimulant poisoning)
  • beta-adrenergic receptor agonists (eg clenbuterol)
  • cocaine
  • novel psychoactive substances, including novel stimulant drugs, synthetic cannabinoid-receptor agonists, and novel hallucinogenic drugs.