TOXIDROMES: Wet vs Dry Symptoms

Medical ExaminerIn last week’s blog, I introduced the concept of toxidromes—defined as a group of specific symptoms and clues which medical examiners use to identify the specific substance used to poison a victim.

In that blog, I discussed two of the most popularDilated Pupils toxidrome categories in modern fiction—Opiod/Opiate Toxidromes and Stimulant Drug Toxidromes. I stated that a central clue to identifying one of those lethal substances was to “look at the eyes” because depressant drugs such as opiates constrict the pupils and stimulant drugs dilate the pupils.

Today I’d like to continue the discussion of toxidromes by presenting two other drug categories that also have telltale clues involving the victim’s eyes and which can lead to a misdiagnosis of a lethal substance. A seasoned murder mystery writer always considers other hidden clues to construct a convincing story and to solve the murder in a believable and accurate fashion, and I hope this blog helps further that cause.

In last week’s blog, I mentioned that there were six general categories of toxidromes in modern toxicology: Opiod, Stimulant, Anticholinergic, Cholinergic, Sedative/Hypnotic and Serotonin Syndrome Substances.

Like those of opiod and stimulant drugs, anticholinergic and cholinergic toxidromes also affect the pupils in a specific telltale manner, and that might lead your medical professional character to a wrong conclusion about the lethal substance unless that character looks for further clues. Anticholinergic and cholinergic drugs produce more specific signs of an overdose that distinguish them from other toxic substances.

Without going into the complicated science behind the mechanism of how anticholinergic vs cholinergic drugs work in the body, the following is a brief discussion of the best ways to identify these drugs as lethal substances in a murder mystery.

Anticholinergic drugs involve several classes of drugs that include antihistamines, tricyclic antidepressants, muscle relaxants, Dry As A Boneantipsychotic drugs, anti-nausea patches and even some asthma medications. The common symptoms of an overdose for all of these drugs are stated as, “hot, dry, blind, red and mad!” The ways medical examiners remember toxic symptoms of these drugs are as follows: “hot as a hare, dry as a bone, blind as a bat, red as a beet and mad as a hatter.” Anticholinergic drugs also cause the pupils of the eye to dilate.

Therefore, it’s important to introduce other telltale signs of an overdose besides the size of the victim’s pupils in your writing. A combination of the above symptoms surely should provide interesting drama in a murder scene and give plenty of clues to your police and medical professional characters to identify the lethal substance and tie it back to your villain.

Cholinergic drugs, on the other hand, produce very WET side effects and the acronym SLUDGE is used most often to remember the symptoms of an overdose of these drugs. SLUDGE refers to Salivation, Lacrimation (tearing), Urination, Diarrhea, GI distress and Emesis. Substances in the generalSludge cholinergic category include muscarine-containing mushrooms, several nerve agents, nicotine, and a variety of insecticides. Cholinergic drugs, however, produce constriction of the pupils of the eye and the combination of the above symptoms with pupil dilation help zero in on cholinergic substances as lethal weapons.

The entire subject of toxidromes can be very complicated and confusing. By doing some basic research into a few simple diagnostic clues, however, a writer can make solving the murder in his/her mystery novel very entertaining for the reader and achieve a level of believability that transforms good writing into GREAT WRITING!

Thoughts? Comments? I’d like to hear them!




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About James J. Murray, Fiction Writer

With experience in both pharmaceutical manufacturing and clinical patient management, medications and their impact on one’s quality of life have been my expertise. My secret passion of murder and mayhem, however, is a whole other matter. I’ve always loved reading murder mysteries and thrillers, and longed to weave such tales of my own. Drawing on my clinical expertise as a pharmacist and my infatuation with the lethal effects of drugs, my tales of murder, mayhem and medicine will have you looking over your shoulder and suspicious of anything in your medicine cabinet.
This entry was posted in A How To Blog on Murder Plot Ideas, A How To Blog on Murder Weapons, About James J. Murray, About Murder, About Writing, Achieving Writing Perfection, All About Murder, Anticholinergic Toxidromes, Blog Writers, Blogging, Bloodless Death Scene Writing, Chemical Poisons, Chemical Weapons Discussions, Chemicals Used For Murder, Cholinergic Toxidromes, Deadly Poisons Discussed, Designer Poisons Used For Murder, Designing Murder Plots, Developing Story Plots, Developing Storyline Ideas, Developing Writing Skills, Difficult to Solve Murders, Dramatic Murder Weapons, Drugs Used For Murder, How to Choose a Murder Weapon for a Plot Idea, Ideas for Murder Scenes, Instruments of Death, Interesting Murder Weapons, James J. Murray Blog, Killing Off Characters in Writing, Lethal Anticholinergic Drug Symptoms, Lethal Chemical Poisons, Lethal Chemicals in Murder Mysteries, Lethal Cholinergic Drug Symptoms, Methods of Murder, Murder Mayhem and Medicine, Murder Weapons, Murder Weapons Discussed, Murder With Drugs, New Blog, New Methods of Murder, Pharmacy/Pharmaceuticals, Poisons and Murder, Poisons Used For Murder, Prescription For Murder Blog, The Science of Murder, The Writings of James J. Murray, Tools of Fiction Writing, Tools of Murder, Toxidromes and Murder, Toxidromes and Murder Mysteries, Toxidromes in Murder Mysteries, Toxidromes to Identify a Poison, Toxidromes to Solve Murders, Unique Lethal Compounds, Unique Murder Plots, Unique Murder Weapons, Ways to Murder, Writing Death Scenes, Writing Dramatic Murder Scenes and tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , . Bookmark the permalink.

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