Jaundice Carbon tetrachloride, acetaminophen, naphthalene, phenothiazines, plants (hepatotoxic mushrooms, fava bean-induced hemolysis), heavy metals (iron, phosphorus, arsenic) Cyanosis (unresponsive to oxygen, as a result of methemoglobinemia) Aniline dyes, nitrites, benzocaine, phenacetin, nitrobenzene, phenazopyridine, dapsone Pinkness to redness Atropinics and antihistamines, alcohol, carbon monoxide, cyanide, boric acid Odors Acetone: Acetone, isopropyl alcohol, phenol, salicylates Alcohol: Ethanol (alcoholic beverages) Bitter almond: Cyanide Garlic: Heavy metal (arsenic, phosphorus, thallium), selenium, organophosphates Wintergreen: Methylsalicylates (oil of wintergreen) Solvent: Hydrocarbons (gasoline, turpentine) OTC, over the counter; LSD, lysergamide Adapted from Mofenson HC, Greensher J The unknown poison Pediatrics 1974;54:336 TABLE 102.6 TOXIDROMES An immediate determination of quantitative levels is helpful in making management decisions for some drugs, and these are outlined in Table 102.7 Furthermore, many important causes of coma and altered vital signs are not detected on even the most sophisticated comprehensive toxicology panels because these are often biased toward psychoactive medications and illicit drugs Drugs detected by most comprehensive screens are presented in Table 102.8