Give some common symptom which exists for some toxins , trick to remember , like bradycardia occurs in these poison etc

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Finding Sources

Searching the Web

toxicology mnemonics bradycardia miosis mydriasis poisons memory tricks SLUD

Reading File

Reading Web Page

https://litfl.com/toxicology-mnemonic-challenge

Excellent! I now have rich data from the Goldman-Cecil textbook and LITFL. Let me compile the full, organized response.

Toxicology Mnemonics: Common Symptoms Across Poisons

Here's a complete, exam-ready breakdown organized by symptom, with mnemonics to remember which toxins cause each.

1. BRADYCARDIA - Mnemonic: "PACED"

Letter	Toxin/Drug
P	Propranolol (beta-blockers), Poppies (opiates), Propoxyphene, Physostigmine
A	Anticholinesterases (cholinergics), Antiarrhythmics
C	Clonidine (alpha-2 agonist), Calcium channel blockers
E	Ethanol and other alcohols
D	Digoxin, Digitalis

Also caused by: organophosphates, carbamates, nerve agents (muscarinic effect).

2. TACHYCARDIA - Mnemonic: "FAST"

Letter	Toxin/Drug
F	Free base cocaine, Freon
A	Anticholinergics, Amphetamines
S	Sympathomimetics, Salicylates
T	Theophylline, TCAs (tricyclic antidepressants)

3. MIOSIS (Pinpoint Pupils) - Mnemonic: "COPS"

Letter	Toxin
C	Cholinergics, Clonidine, Carbamates
O	Opioids, Organophosphates
P	Phenothiazines (antipsychotics), Pilocarpine, Pontine hemorrhage
S	Sedative-hypnotics

4. MYDRIASIS (Dilated Pupils) - Mnemonic: "SAW"

Letter	Toxin
S	Sympathomimetics (cocaine, amphetamines)
A	Anticholinergics (atropine, antihistamines, TCAs, Datura)
W	Withdrawal syndromes (opioid, alcohol, benzo withdrawal)

5. SEIZURES - Mnemonic: "OTIS CAMPBELL"

Letter	Toxin
O	Organophosphates, Oral hypoglycemics
T	Tricyclic antidepressants (TCAs)
I	Isoniazid (INH), Insulin
S	Sympathomimetics, Strychnine, Salicylates
C	Camphor, Cocaine, Carbon monoxide, Cyanide, Chlorinated hydrocarbons
A	Amphetamines, Anticholinergics
M	Methylxanthines (theophylline, caffeine), Methanol
P	Phencyclidine (PCP), Propranolol
B	Benzo withdrawal, Botanicals (water hemlock, nicotine), Bupropion, GHB
E	Ethanol withdrawal, Ethylene glycol
L	Lithium, Lidocaine
L	Lead, Lindane

Otis Campbell is the town drunk from The Andy Griffith Show - a fun way to remember seizure-causing toxins!

6. COMA - Mnemonic: "LETHARGIC"

Letter	Toxin
L	Lead, Lithium
E	Ethanol, Ethylene glycol
T	TCAs, Thallium, Toluene
H	Heroin, Hemlock, Heavy metals, Hydrogen sulfide, Hypoglycemics
A	Arsenic, Antidepressants, Anticonvulsants, Antipsychotics, Antihistamines
R	Rohypnol (sedative-hypnotics), Risperidone
G	GHB
I	Isoniazid, Insulin
C	Carbon monoxide, Cyanide, Clonidine

7. The 5 Classic TOXIDROMES (Side-by-Side)

Toxidrome	HR	BP	Pupils	Skin	Other Clues
Cholinergic (OPs, nerve agents)	Low	Variable	Miosis	Wet, diaphoretic	SLUDGE - Salivation, Lacrimation, Urination, Defecation, GI upset, Emesis
Anticholinergic (atropine, Datura, antihistamines)	High	Normal/High	Mydriasis	Dry, flushed, hot	"Blind as a bat, Mad as a hatter, Red as a beet, Hot as Hades, Dry as a bone"
Sympathomimetic (cocaine, amphetamines)	High	High	Mydriasis	Wet (diaphoresis)	Agitation, hyperthermia, seizures
Opioid (heroin, fentanyl, morphine)	Low	Low	Miosis	Dry	CNS depression, respiratory depression, responds to naloxone
Sedative-hypnotic (benzos, barbiturates, ethanol)	Normal	Mildly low	Normal	Normal	Ataxia, CNS depression, slurred speech - no miosis

8. CHOLINERGIC Toxidrome in Detail

Muscarinic effects - Mnemonic: "DUMBELLS"

Letter	Effect
D	Diarrhea, Diaphoresis
U	Urination
M	Miosis
B	Bradycardia, Bronchospasm, Bronchorrhea
E	Emesis
L	Lacrimation
L	Lethargy
S	Salivation

Nicotinic effects - "Days of the Week" (M-T-W-T-F)

Day	Effect
Monday	Mydriasis
Tuesday	Tachycardia
Wednesday	Weakness
Thursday	Tremors/Fasciculations
Friday	Fasciculations/Seizures

Note: Nicotinic effects (tachycardia, mydriasis) can appear early and seem contradictory - remember "weekdays" to separate them from the muscarinic DUMBELLS.

9. ANTICHOLINERGIC - The Classic Poem

"Blind as a bat" (mydriasis, blurred vision) "Mad as a hatter" (agitation, delirium, hallucinations) "Red as a beet" (flushed skin - vasodilation) "Hot as Hades" (hyperthermia - no sweating) "Dry as a bone" (anhidrosis, dry mouth) "The bowel and bladder lose their tone, and the heart runs alone" (urinary retention, constipation, tachycardia)

Or the simpler version: "Can't See, Can't Pee, Can't Spit, Can't Shit"

10. DIALYZABLE Toxins - Mnemonic: "PLASMA TV"

Letter	Toxin
P	Phenobarbital
L	Lithium
A	Acidosis (methanol, ethylene glycol)
S	Salicylates
M	Metformin
A	Alcohols
T	Theophylline
V	Valproic acid

Quick Summary Card

Symptom	Key Toxins	Mnemonic
Bradycardia	Beta-blockers, Opioids, Clonidine, Ca-channel blockers, Digoxin, Cholinergics	PACED
Tachycardia	Anticholinergics, Amphetamines, Sympathomimetics, Theophylline	FAST
Miosis	Opioids, Organophosphates, Clonidine, Phenothiazines	COPS
Mydriasis	Sympathomimetics, Anticholinergics, Withdrawal	SAW
Seizures	Isoniazid, TCAs, Cocaine, OPs, Theophylline...	OTIS CAMPBELL
Coma	Opioids, Ethanol, GHB, Heavy metals, Cyanide...	LETHARGIC
Wet skin	Cholinergics, Sympathomimetics	-
Dry skin	Anticholinergics	-

Sources: [Goldman-Cecil Medicine, Table 96 - Toxidromes], LITFL Toxicology Mnemonic Challenge

Create a quick reference PDF flashcard of toxidrome mnemonics

Reading File

Running Command

ls -la /tmp/workspace/ 2>/dev/null || echo "workspace empty or missing"

Running Command

mkdir -p /tmp/workspace/toxidrome-flashcards

Writing File

~/toxidrome-flashcards/generate_pdf.py

from reportlab.lib.pagesizes import A4
from reportlab.lib import colors
from reportlab.lib.units import mm, cm
from reportlab.platypus import (
    SimpleDocTemplate, Paragraph, Spacer, Table, TableStyle,
    HRFlowable, KeepTogether
)
from reportlab.lib.styles import getSampleStyleSheet, ParagraphStyle
from reportlab.lib.enums import TA_CENTER, TA_LEFT, TA_RIGHT
from reportlab.platypus import PageBreak

OUTPUT = "/tmp/workspace/toxidrome-flashcards/Toxidrome_Mnemonics_Flashcard.pdf"

# ── Colour palette ──────────────────────────────────────────────────────────
C_BG        = colors.HexColor("#0D1B2A")   # deep navy
C_CARD1     = colors.HexColor("#1A2E45")   # card bg
C_ACCENT1   = colors.HexColor("#00BCD4")   # cyan  (cholinergic)
C_ACCENT2   = colors.HexColor("#FF7043")   # orange (anticholinergic)
C_ACCENT3   = colors.HexColor("#66BB6A")   # green  (opioid)
C_ACCENT4   = colors.HexColor("#AB47BC")   # purple (sympathomimetic)
C_ACCENT5   = colors.HexColor("#FFA726")   # amber  (sedative-hypnotic)
C_ACCENT6   = colors.HexColor("#EF5350")   # red    (bradycardia/PACED)
C_ACCENT7   = colors.HexColor("#29B6F6")   # blue   (miosis/COPS)
C_ACCENT8   = colors.HexColor("#EC407A")   # pink   (seizures)
C_ACCENT9   = colors.HexColor("#8D6E63")   # brown  (coma)
C_WHITE     = colors.white
C_LIGHT     = colors.HexColor("#E0F7FA")
C_YELLOW    = colors.HexColor("#FFF9C4")
C_DARK_TEXT = colors.HexColor("#1A1A2E")

# ── Styles ──────────────────────────────────────────────────────────────────
styles = getSampleStyleSheet()

def S(name, **kw):
    return ParagraphStyle(name, **kw)

title_style = S("title",
    fontSize=22, fontName="Helvetica-Bold",
    textColor=C_WHITE, alignment=TA_CENTER,
    spaceAfter=4)

subtitle_style = S("subtitle",
    fontSize=11, fontName="Helvetica",
    textColor=C_ACCENT1, alignment=TA_CENTER,
    spaceAfter=2)

card_header_style = S("card_header",
    fontSize=13, fontName="Helvetica-Bold",
    textColor=C_WHITE, alignment=TA_LEFT,
    spaceAfter=2, leading=16)

mnemonic_style = S("mnemonic",
    fontSize=16, fontName="Helvetica-Bold",
    textColor=C_YELLOW, alignment=TA_CENTER,
    spaceAfter=4, leading=20)

poem_style = S("poem",
    fontSize=9, fontName="Helvetica-Oblique",
    textColor=C_LIGHT, alignment=TA_CENTER,
    leading=14, spaceAfter=2)

body_style = S("body",
    fontSize=9, fontName="Helvetica",
    textColor=C_WHITE, leading=13)

letter_style = S("letter",
    fontSize=11, fontName="Helvetica-Bold",
    textColor=C_YELLOW, leading=14)

table_body = S("table_body",
    fontSize=8.5, fontName="Helvetica",
    textColor=C_DARK_TEXT, leading=12)

table_header = S("table_header",
    fontSize=9, fontName="Helvetica-Bold",
    textColor=C_WHITE, leading=12)

section_title = S("section_title",
    fontSize=14, fontName="Helvetica-Bold",
    textColor=C_YELLOW, alignment=TA_CENTER,
    spaceAfter=6, spaceBefore=8)

footer_style = S("footer",
    fontSize=7, fontName="Helvetica",
    textColor=colors.HexColor("#607D8B"),
    alignment=TA_CENTER)

# ── Helper: make a coloured card ────────────────────────────────────────────
def card(content_rows, accent, col_widths, title_row=None):
    """Wrap a list of [col1, col2] rows in a styled table."""
    data = []
    if title_row:
        data.append(title_row)
    data.extend(content_rows)

    ts = TableStyle([
        ("BACKGROUND",   (0, 0), (-1, -1), C_CARD1),
        ("ROWBACKGROUNDS",(0, 0), (-1, -1), [C_CARD1, colors.HexColor("#162235")]),
        ("LEFTPADDING",  (0, 0), (-1, -1), 8),
        ("RIGHTPADDING", (0, 0), (-1, -1), 8),
        ("TOPPADDING",   (0, 0), (-1, -1), 5),
        ("BOTTOMPADDING",(0, 0), (-1, -1), 5),
        ("ROUNDEDCORNERS", (0, 0), (-1, -1), 4),
        ("BOX",          (0, 0), (-1, -1), 1.5, accent),
        ("LINEBELOW",    (0, 0), (-1, 0), 1, accent),
        ("VALIGN",       (0, 0), (-1, -1), "TOP"),
    ])
    if title_row:
        ts.add("BACKGROUND", (0, 0), (-1, 0), accent)
        ts.add("SPAN", (0, 0), (-1, 0))

    t = Table(data, colWidths=col_widths)
    t.setStyle(ts)
    return t


def make_letter_table(letter_data, accent, col_widths=(18*mm, 145*mm)):
    """letter_data: list of (letter, description)"""
    rows = []
    for ltr, desc in letter_data:
        rows.append([
            Paragraph(ltr, letter_style),
            Paragraph(desc, body_style),
        ])
    ts = TableStyle([
        ("BACKGROUND",    (0, 0), (-1, -1), C_CARD1),
        ("ROWBACKGROUNDS",(0, 0), (-1, -1), [C_CARD1, colors.HexColor("#162235")]),
        ("LEFTPADDING",   (0, 0), (-1, -1), 6),
        ("RIGHTPADDING",  (0, 0), (-1, -1), 6),
        ("TOPPADDING",    (0, 0), (-1, -1), 4),
        ("BOTTOMPADDING", (0, 0), (-1, -1), 4),
        ("BOX",           (0, 0), (-1, -1), 1.5, accent),
        ("LINEBEFORE",    (0, 0), (0, -1), 3, accent),
        ("VALIGN",        (0, 0), (-1, -1), "TOP"),
    ])
    t = Table(rows, colWidths=list(col_widths))
    t.setStyle(ts)
    return t


def header_banner(text, accent):
    data = [[Paragraph(text, card_header_style)]]
    ts = TableStyle([
        ("BACKGROUND",   (0, 0), (-1, -1), accent),
        ("LEFTPADDING",  (0, 0), (-1, -1), 10),
        ("RIGHTPADDING", (0, 0), (-1, -1), 10),
        ("TOPPADDING",   (0, 0), (-1, -1), 6),
        ("BOTTOMPADDING",(0, 0), (-1, -1), 6),
        ("ROUNDEDCORNERS",(0, 0),(-1, -1), 3),
    ])
    t = Table(data, colWidths=[168*mm])
    t.setStyle(ts)
    return t


# ── Page background ──────────────────────────────────────────────────────────
def on_page(canvas, doc):
    canvas.saveState()
    canvas.setFillColor(C_BG)
    canvas.rect(0, 0, A4[0], A4[1], fill=1, stroke=0)
    # footer
    canvas.setFont("Helvetica", 7)
    canvas.setFillColor(colors.HexColor("#455A64"))
    canvas.drawCentredString(A4[0]/2, 10*mm,
        "Toxidrome Mnemonics Quick Reference  •  Sources: Goldman-Cecil Medicine, LITFL")
    canvas.restoreState()


# ══════════════════════════════════════════════════════════════════════════════
# BUILD DOCUMENT
# ══════════════════════════════════════════════════════════════════════════════
doc = SimpleDocTemplate(
    OUTPUT,
    pagesize=A4,
    leftMargin=20*mm, rightMargin=20*mm,
    topMargin=18*mm, bottomMargin=18*mm,
)

story = []

# ── Cover banner ──────────────────────────────────────────────────────────────
cover_data = [[
    Paragraph("☠ TOXIDROME MNEMONICS", title_style),
    Paragraph("Quick Reference Flashcard", subtitle_style),
    Paragraph("Bradycardia · Tachycardia · Miosis · Mydriasis · Seizures · Coma · Cholinergic · Anticholinergic · Opioid · Sympathomimetic", subtitle_style),
]]
cover_ts = TableStyle([
    ("BACKGROUND",   (0,0),(-1,-1), colors.HexColor("#0A1628")),
    ("BOX",          (0,0),(-1,-1), 2, C_ACCENT1),
    ("LEFTPADDING",  (0,0),(-1,-1), 12),
    ("RIGHTPADDING", (0,0),(-1,-1), 12),
    ("TOPPADDING",   (0,0),(-1,-1), 10),
    ("BOTTOMPADDING",(0,0),(-1,-1), 10),
    ("ALIGN",        (0,0),(-1,-1), "CENTER"),
    ("VALIGN",       (0,0),(-1,-1), "MIDDLE"),
])
cover_t = Table(cover_data, colWidths=[168*mm])
cover_t.setStyle(cover_ts)
story.append(cover_t)
story.append(Spacer(1, 6*mm))

# ════════════════════════════════════════════════════════
# SECTION 1 – SYMPTOM-BASED MNEMONICS (2-column layout)
# ════════════════════════════════════════════════════════
story.append(Paragraph("▸  SYMPTOM-BASED MNEMONICS", section_title))

# Left card: BRADYCARDIA (PACED) | Right card: TACHYCARDIA (FAST)
paced_rows = [
    ("P", "Propranolol (beta-blockers), Poppies (opiates), Propoxyphene, Physostigmine"),
    ("A", "Anticholinesterases (cholinergics), Antiarrhythmics"),
    ("C", "Clonidine (alpha-2 agonist), Calcium channel blockers"),
    ("E", "Ethanol and other alcohols"),
    ("D", "Digoxin, Digitalis"),
]

fast_rows = [
    ("F", "Free base cocaine, Freon"),
    ("A", "Anticholinergics, Amphetamines"),
    ("S", "Sympathomimetics, Salicylates"),
    ("T", "Theophylline, TCAs (tricyclics)"),
]

def mini_letter_table(rows, accent, lw=12*mm, dw=60*mm):
    data = [[Paragraph(l, letter_style), Paragraph(d, S("d", fontSize=8, fontName="Helvetica", textColor=C_WHITE, leading=11))]
            for l,d in rows]
    ts = TableStyle([
        ("BACKGROUND",    (0,0),(-1,-1), C_CARD1),
        ("ROWBACKGROUNDS",(0,0),(-1,-1), [C_CARD1, colors.HexColor("#162235")]),
        ("LEFTPADDING",   (0,0),(-1,-1), 4),
        ("RIGHTPADDING",  (0,0),(-1,-1), 4),
        ("TOPPADDING",    (0,0),(-1,-1), 3),
        ("BOTTOMPADDING", (0,0),(-1,-1), 3),
        ("LINEBEFORE",    (0,0),(0,-1),  3, accent),
        ("VALIGN",        (0,0),(-1,-1), "TOP"),
    ])
    t = Table(data, colWidths=[lw, dw])
    t.setStyle(ts)
    return t

def symptom_card(title, mnemonic, rows, accent, width=80*mm):
    lw = 10*mm; dw = width - lw - 6*mm
    inner = mini_letter_table(rows, accent, lw, dw)
    data = [
        [Paragraph(f"<b>{title}</b>", S("ch", fontSize=10, fontName="Helvetica-Bold", textColor=C_WHITE, leading=13))],
        [Paragraph(mnemonic, S("mn", fontSize=18, fontName="Helvetica-Bold", textColor=C_YELLOW, alignment=TA_CENTER, leading=22))],
        [inner],
    ]
    ts = TableStyle([
        ("BACKGROUND",   (0,0),(-1,-1), C_CARD1),
        ("BACKGROUND",   (0,0),(-1,0),  accent),
        ("BOX",          (0,0),(-1,-1), 1.5, accent),
        ("LEFTPADDING",  (0,0),(-1,-1), 6),
        ("RIGHTPADDING", (0,0),(-1,-1), 6),
        ("TOPPADDING",   (0,0),(-1,-1), 4),
        ("BOTTOMPADDING",(0,0),(-1,-1), 4),
        ("ALIGN",        (0,1),(-1,1),  "CENTER"),
        ("VALIGN",       (0,0),(-1,-1), "TOP"),
    ])
    t = Table(data, colWidths=[width - 2*mm])
    t.setStyle(ts)
    return t

brad_card = symptom_card("🫀 BRADYCARDIA", "PACED", paced_rows, C_ACCENT6, 82*mm)
tach_card = symptom_card("💓 TACHYCARDIA", "FAST",  fast_rows,  C_ACCENT5, 82*mm)

row1 = Table([[brad_card, tach_card]], colWidths=[84*mm, 84*mm])
row1.setStyle(TableStyle([
    ("LEFTPADDING",  (0,0),(-1,-1), 2),
    ("RIGHTPADDING", (0,0),(-1,-1), 2),
    ("TOPPADDING",   (0,0),(-1,-1), 0),
    ("BOTTOMPADDING",(0,0),(-1,-1), 0),
    ("VALIGN",       (0,0),(-1,-1), "TOP"),
]))
story.append(row1)
story.append(Spacer(1, 4*mm))

# MIOSIS (COPS) | MYDRIASIS (SAW)
cops_rows = [
    ("C", "Cholinergics, Clonidine, Carbamates"),
    ("O", "Opioids, Organophosphates"),
    ("P", "Phenothiazines, Pilocarpine, Pontine bleed"),
    ("S", "Sedative-hypnotics"),
]
saw_rows = [
    ("S", "Sympathomimetics (cocaine, amphetamines)"),
    ("A", "Anticholinergics (atropine, antihistamines)"),
    ("W", "Withdrawal (opioid, alcohol, benzo)"),
]

miosis_card  = symptom_card("👁 MIOSIS (Pinpoint)",  "COPS", cops_rows, C_ACCENT7, 82*mm)
mydrias_card = symptom_card("👁 MYDRIASIS (Dilated)", "SAW",  saw_rows,  C_ACCENT4, 82*mm)

row2 = Table([[miosis_card, mydrias_card]], colWidths=[84*mm, 84*mm])
row2.setStyle(TableStyle([
    ("LEFTPADDING",  (0,0),(-1,-1), 2),
    ("RIGHTPADDING", (0,0),(-1,-1), 2),
    ("TOPPADDING",   (0,0),(-1,-1), 0),
    ("BOTTOMPADDING",(0,0),(-1,-1), 0),
    ("VALIGN",       (0,0),(-1,-1), "TOP"),
]))
story.append(row2)
story.append(Spacer(1, 4*mm))

# SEIZURES – OTIS CAMPBELL (full width)
story.append(header_banner("⚡ SEIZURES  —  OTIS CAMPBELL", C_ACCENT8))
otis_rows = [
    ("O", "Organophosphates, Oral hypoglycemics"),
    ("T", "Tricyclic antidepressants (TCAs)"),
    ("I", "Isoniazid (INH), Insulin"),
    ("S", "Sympathomimetics, Strychnine, Salicylates"),
    ("C", "Camphor, Cocaine, CO, Cyanide, Chlorinated HCs"),
    ("A", "Amphetamines, Anticholinergics"),
    ("M", "Methylxanthines (theophylline/caffeine), Methanol"),
    ("P", "Phencyclidine (PCP), Propranolol"),
    ("B", "Benzo withdrawal, Botanicals, Bupropion, GHB"),
    ("E", "Ethanol withdrawal, Ethylene glycol"),
    ("L", "Lithium, Lidocaine"),
    ("L", "Lead, Lindane"),
]
# 3-column layout for OTIS
otis_col1 = otis_rows[:4]
otis_col2 = otis_rows[4:8]
otis_col3 = otis_rows[8:]

def otis_col(rows, accent=C_ACCENT8):
    data = [[Paragraph(l, S("ol",fontSize=11,fontName="Helvetica-Bold",textColor=C_YELLOW,leading=14)),
             Paragraph(d, S("od",fontSize=8,fontName="Helvetica",textColor=C_WHITE,leading=11))]
            for l,d in rows]
    ts = TableStyle([
        ("BACKGROUND",    (0,0),(-1,-1), C_CARD1),
        ("ROWBACKGROUNDS",(0,0),(-1,-1), [C_CARD1, colors.HexColor("#162235")]),
        ("LEFTPADDING",   (0,0),(-1,-1), 4),
        ("RIGHTPADDING",  (0,0),(-1,-1), 4),
        ("TOPPADDING",    (0,0),(-1,-1), 3),
        ("BOTTOMPADDING", (0,0),(-1,-1), 3),
        ("LINEBEFORE",    (0,0),(0,-1),  3, accent),
        ("VALIGN",        (0,0),(-1,-1), "TOP"),
    ])
    t = Table(data, colWidths=[10*mm, 44*mm])
    t.setStyle(ts)
    return t

otis_table = Table(
    [[otis_col(otis_col1), otis_col(otis_col2), otis_col(otis_col3)]],
    colWidths=[56*mm, 56*mm, 56*mm]
)
otis_table.setStyle(TableStyle([
    ("BACKGROUND", (0,0),(-1,-1), C_CARD1),
    ("BOX",        (0,0),(-1,-1), 1.5, C_ACCENT8),
    ("LEFTPADDING",(0,0),(-1,-1), 2),
    ("RIGHTPADDING",(0,0),(-1,-1), 2),
    ("TOPPADDING",  (0,0),(-1,-1), 4),
    ("BOTTOMPADDING",(0,0),(-1,-1), 4),
    ("VALIGN",     (0,0),(-1,-1), "TOP"),
]))
story.append(otis_table)
story.append(Spacer(1, 4*mm))

# COMA – LETHARGIC
story.append(header_banner("💤 COMA  —  LETHARGIC", C_ACCENT9))
lethargic_rows = [
    ("L", "Lead, Lithium"),
    ("E", "Ethanol, Ethylene glycol"),
    ("T", "TCAs, Thallium, Toluene"),
    ("H", "Heroin, Hemlock, Heavy metals, Hydrogen sulfide, Hypoglycemics"),
    ("A", "Arsenic, Antidepressants, Anticonvulsants, Antipsychotics, Antihistamines"),
    ("R", "Rohypnol (sedative-hypnotics), Risperidone"),
    ("G", "GHB"),
    ("I", "Isoniazid, Insulin"),
    ("C", "Carbon monoxide, Cyanide, Clonidine"),
]
leth_col1 = lethargic_rows[:5]
leth_col2 = lethargic_rows[5:]

def leth_col(rows, w1=10*mm, w2=68*mm):
    data = [[Paragraph(l, S("ll",fontSize=11,fontName="Helvetica-Bold",textColor=C_YELLOW,leading=14)),
             Paragraph(d, S("ld",fontSize=8,fontName="Helvetica",textColor=C_WHITE,leading=11))]
            for l,d in rows]
    ts = TableStyle([
        ("BACKGROUND",    (0,0),(-1,-1), C_CARD1),
        ("ROWBACKGROUNDS",(0,0),(-1,-1), [C_CARD1, colors.HexColor("#162235")]),
        ("LEFTPADDING",   (0,0),(-1,-1), 4),
        ("RIGHTPADDING",  (0,0),(-1,-1), 4),
        ("TOPPADDING",    (0,0),(-1,-1), 3),
        ("BOTTOMPADDING", (0,0),(-1,-1), 3),
        ("LINEBEFORE",    (0,0),(0,-1),  3, C_ACCENT9),
        ("VALIGN",        (0,0),(-1,-1), "TOP"),
    ])
    t = Table(data, colWidths=[w1, w2])
    t.setStyle(ts)
    return t

leth_table = Table(
    [[leth_col(leth_col1), leth_col(leth_col2)]],
    colWidths=[84*mm, 84*mm]
)
leth_table.setStyle(TableStyle([
    ("BACKGROUND",  (0,0),(-1,-1), C_CARD1),
    ("BOX",         (0,0),(-1,-1), 1.5, C_ACCENT9),
    ("LEFTPADDING", (0,0),(-1,-1), 2),
    ("RIGHTPADDING",(0,0),(-1,-1), 2),
    ("TOPPADDING",  (0,0),(-1,-1), 4),
    ("BOTTOMPADDING",(0,0),(-1,-1), 4),
    ("VALIGN",      (0,0),(-1,-1), "TOP"),
]))
story.append(leth_table)
story.append(Spacer(1, 4*mm))

# DIALYZABLE – PLASMA TV
story.append(header_banner("🩸 DIALYZABLE TOXINS  —  PLASMA TV", colors.HexColor("#26C6DA")))
plasma_rows = [
    ("P","Phenobarbital"), ("L","Lithium"), ("A","Acidosis (methanol, ethylene glycol)"),
    ("S","Salicylates"), ("M","Metformin"), ("A","Alcohols"),
    ("T","Theophylline"), ("V","Valproic acid"),
]
plasma_data = [[Paragraph(l, S("pl",fontSize=11,fontName="Helvetica-Bold",textColor=C_YELLOW,leading=14)),
                Paragraph(d, S("pd",fontSize=9,fontName="Helvetica",textColor=C_WHITE,leading=12))]
               for l,d in plasma_rows]
plasma_ts = TableStyle([
    ("BACKGROUND",    (0,0),(-1,-1), C_CARD1),
    ("ROWBACKGROUNDS",(0,0),(-1,-1), [C_CARD1, colors.HexColor("#162235")]),
    ("LEFTPADDING",   (0,0),(-1,-1), 8),
    ("RIGHTPADDING",  (0,0),(-1,-1), 8),
    ("TOPPADDING",    (0,0),(-1,-1), 3),
    ("BOTTOMPADDING", (0,0),(-1,-1), 3),
    ("LINEBEFORE",    (0,0),(0,-1),  3, colors.HexColor("#26C6DA")),
    ("BOX",           (0,0),(-1,-1), 1.5, colors.HexColor("#26C6DA")),
    ("VALIGN",        (0,0),(-1,-1), "TOP"),
])
# Split into 2 columns of 4
plasma_left  = plasma_rows[:4]
plasma_right = plasma_rows[4:]

def plasma_col(rows):
    data = [[Paragraph(l, S("pl2",fontSize=11,fontName="Helvetica-Bold",textColor=C_YELLOW,leading=14)),
             Paragraph(d, S("pd2",fontSize=9,fontName="Helvetica",textColor=C_WHITE,leading=12))]
            for l,d in rows]
    ts = TableStyle([
        ("BACKGROUND",    (0,0),(-1,-1), C_CARD1),
        ("ROWBACKGROUNDS",(0,0),(-1,-1), [C_CARD1, colors.HexColor("#162235")]),
        ("LEFTPADDING",   (0,0),(-1,-1), 6),
        ("RIGHTPADDING",  (0,0),(-1,-1), 6),
        ("TOPPADDING",    (0,0),(-1,-1), 3),
        ("BOTTOMPADDING", (0,0),(-1,-1), 3),
        ("LINEBEFORE",    (0,0),(0,-1),  3, colors.HexColor("#26C6DA")),
        ("VALIGN",        (0,0),(-1,-1), "TOP"),
    ])
    t = Table(data, colWidths=[10*mm, 70*mm])
    t.setStyle(ts)
    return t

plasma_table = Table([[plasma_col(plasma_left), plasma_col(plasma_right)]], colWidths=[84*mm, 84*mm])
plasma_table.setStyle(TableStyle([
    ("BACKGROUND",  (0,0),(-1,-1), C_CARD1),
    ("BOX",         (0,0),(-1,-1), 1.5, colors.HexColor("#26C6DA")),
    ("LEFTPADDING", (0,0),(-1,-1), 2),
    ("RIGHTPADDING",(0,0),(-1,-1), 2),
    ("TOPPADDING",  (0,0),(-1,-1), 4),
    ("BOTTOMPADDING",(0,0),(-1,-1), 4),
    ("VALIGN",      (0,0),(-1,-1), "TOP"),
]))
story.append(plasma_table)

# ────────────────────────── PAGE 2 ──────────────────────────────────────────
story.append(PageBreak())

story.append(Paragraph("▸  THE 5 CLASSIC TOXIDROMES", section_title))

# Big comparison table
tox_headers = ["Toxidrome", "HR", "BP", "Pupils", "Skin", "Key Clue / Mnemonic"]
tox_data = [
    [Paragraph(h, S("th",fontSize=9,fontName="Helvetica-Bold",textColor=C_WHITE,leading=12)) for h in tox_headers],
    [
        Paragraph("🧪 Cholinergic\n(OPs, nerve agents, carbamates)", S("tc",fontSize=8.5,fontName="Helvetica-Bold",textColor=C_ACCENT1,leading=12)),
        Paragraph("↓ Low", S("tv",fontSize=8.5,fontName="Helvetica",textColor=colors.HexColor("#EF9A9A"),leading=12)),
        Paragraph("Variable", S("tv",fontSize=8.5,fontName="Helvetica",textColor=C_WHITE,leading=12)),
        Paragraph("Miosis\n(pinpoint)", S("tv",fontSize=8.5,fontName="Helvetica",textColor=C_LIGHT,leading=12)),
        Paragraph("Wet\n(diaphoresis)", S("tv",fontSize=8.5,fontName="Helvetica",textColor=C_LIGHT,leading=12)),
        Paragraph("DUMBELLS / SLUDGE\nBronchorrhea, fasciculations", S("tv",fontSize=8,fontName="Helvetica",textColor=C_YELLOW,leading=11)),
    ],
    [
        Paragraph("🌵 Anticholinergic\n(atropine, antihistamines, Datura, TCAs)", S("tc",fontSize=8.5,fontName="Helvetica-Bold",textColor=C_ACCENT2,leading=12)),
        Paragraph("↑ High", S("tv",fontSize=8.5,fontName="Helvetica",textColor=colors.HexColor("#A5D6A7"),leading=12)),
        Paragraph("Normal/High", S("tv",fontSize=8.5,fontName="Helvetica",textColor=C_WHITE,leading=12)),
        Paragraph("Mydriasis\n(dilated)", S("tv",fontSize=8.5,fontName="Helvetica",textColor=C_LIGHT,leading=12)),
        Paragraph("Dry, Hot\nFlushed", S("tv",fontSize=8.5,fontName="Helvetica",textColor=C_LIGHT,leading=12)),
        Paragraph("'Blind as a bat, Mad as a hatter,\nRed as a beet, Dry as a bone'", S("tv",fontSize=8,fontName="Helvetica-Oblique",textColor=C_YELLOW,leading=11)),
    ],
    [
        Paragraph("⚡ Sympathomimetic\n(cocaine, amphetamines, ephedrine)", S("tc",fontSize=8.5,fontName="Helvetica-Bold",textColor=C_ACCENT4,leading=12)),
        Paragraph("↑ High", S("tv",fontSize=8.5,fontName="Helvetica",textColor=colors.HexColor("#A5D6A7"),leading=12)),
        Paragraph("↑ High", S("tv",fontSize=8.5,fontName="Helvetica",textColor=colors.HexColor("#A5D6A7"),leading=12)),
        Paragraph("Mydriasis", S("tv",fontSize=8.5,fontName="Helvetica",textColor=C_LIGHT,leading=12)),
        Paragraph("Wet\n(diaphoresis)", S("tv",fontSize=8.5,fontName="Helvetica",textColor=C_LIGHT,leading=12)),
        Paragraph("Agitation, hyperthermia,\nseizures possible", S("tv",fontSize=8,fontName="Helvetica",textColor=C_YELLOW,leading=11)),
    ],
    [
        Paragraph("💊 Opioid\n(heroin, fentanyl, morphine, clonidine)", S("tc",fontSize=8.5,fontName="Helvetica-Bold",textColor=C_ACCENT3,leading=12)),
        Paragraph("↓ Low", S("tv",fontSize=8.5,fontName="Helvetica",textColor=colors.HexColor("#EF9A9A"),leading=12)),
        Paragraph("↓ Low", S("tv",fontSize=8.5,fontName="Helvetica",textColor=colors.HexColor("#EF9A9A"),leading=12)),
        Paragraph("Miosis\n(pinpoint)", S("tv",fontSize=8.5,fontName="Helvetica",textColor=C_LIGHT,leading=12)),
        Paragraph("Dry", S("tv",fontSize=8.5,fontName="Helvetica",textColor=C_LIGHT,leading=12)),
        Paragraph("CNS/resp. depression\n→ Naloxone reverses", S("tv",fontSize=8,fontName="Helvetica",textColor=C_YELLOW,leading=11)),
    ],
    [
        Paragraph("😴 Sedative-Hypnotic\n(benzos, barbiturates, ethanol, GHB)", S("tc",fontSize=8.5,fontName="Helvetica-Bold",textColor=C_ACCENT5,leading=12)),
        Paragraph("Normal", S("tv",fontSize=8.5,fontName="Helvetica",textColor=C_WHITE,leading=12)),
        Paragraph("Mild ↓", S("tv",fontSize=8.5,fontName="Helvetica",textColor=C_WHITE,leading=12)),
        Paragraph("Normal", S("tv",fontSize=8.5,fontName="Helvetica",textColor=C_LIGHT,leading=12)),
        Paragraph("Normal", S("tv",fontSize=8.5,fontName="Helvetica",textColor=C_LIGHT,leading=12)),
        Paragraph("Ataxia, slurred speech,\nCNS depression — NO miosis", S("tv",fontSize=8,fontName="Helvetica",textColor=C_YELLOW,leading=11)),
    ],
]
tox_ts = TableStyle([
    ("BACKGROUND",   (0,0),(-1,0), colors.HexColor("#1A2E45")),
    ("ROWBACKGROUNDS",(0,1),(-1,-1), [C_CARD1, colors.HexColor("#162235")]),
    ("GRID",         (0,0),(-1,-1), 0.5, colors.HexColor("#2A4A65")),
    ("BOX",          (0,0),(-1,-1), 1.5, C_ACCENT1),
    ("LEFTPADDING",  (0,0),(-1,-1), 6),
    ("RIGHTPADDING", (0,0),(-1,-1), 6),
    ("TOPPADDING",   (0,0),(-1,-1), 5),
    ("BOTTOMPADDING",(0,0),(-1,-1), 5),
    ("VALIGN",       (0,0),(-1,-1), "TOP"),
    # colour-code first column
    ("BACKGROUND",   (0,1),( 0,1), colors.HexColor("#003840")),
    ("BACKGROUND",   (0,2),( 0,2), colors.HexColor("#3B1A0A")),
    ("BACKGROUND",   (0,3),( 0,3), colors.HexColor("#2A0A3B")),
    ("BACKGROUND",   (0,4),( 0,4), colors.HexColor("#0A3B18")),
    ("BACKGROUND",   (0,5),( 0,5), colors.HexColor("#3B2E0A")),
])
tox_table = Table(tox_data,
    colWidths=[44*mm, 12*mm, 14*mm, 17*mm, 17*mm, 62*mm])
tox_table.setStyle(tox_ts)
story.append(tox_table)
story.append(Spacer(1, 5*mm))

# ── CHOLINERGIC DETAIL CARDS ──────────────────────────────────────────────
story.append(Paragraph("▸  CHOLINERGIC TOXIDROME — DETAIL", section_title))

dumbell_rows = [
    ("D", "Diarrhea, Diaphoresis"),
    ("U", "Urination"),
    ("M", "Miosis"),
    ("B", "Bradycardia, Bronchospasm, Bronchorrhea"),
    ("E", "Emesis"),
    ("L", "Lacrimation"),
    ("L", "Lethargy / altered consciousness"),
    ("S", "Salivation"),
]
weekday_rows = [
    ("Mon", "Mydriasis (nicotinic)"),
    ("Tue", "Tachycardia (nicotinic)"),
    ("Wed", "Weakness"),
    ("Thu", "Tremors / Fasciculations"),
    ("Fri", "Fasciculations / Seizures"),
]

def detail_card(title, mnemonic, rows, accent, lw=14*mm, dw=52*mm, width=72*mm):
    data_rows = [[Paragraph(l, S("dl",fontSize=10,fontName="Helvetica-Bold",textColor=C_YELLOW,leading=13)),
                  Paragraph(d, S("dd",fontSize=8.5,fontName="Helvetica",textColor=C_WHITE,leading=12))]
                 for l,d in rows]
    inner_ts = TableStyle([
        ("BACKGROUND",    (0,0),(-1,-1), C_CARD1),
        ("ROWBACKGROUNDS",(0,0),(-1,-1), [C_CARD1, colors.HexColor("#162235")]),
        ("LEFTPADDING",   (0,0),(-1,-1), 4),
        ("RIGHTPADDING",  (0,0),(-1,-1), 4),
        ("TOPPADDING",    (0,0),(-1,-1), 3),
        ("BOTTOMPADDING", (0,0),(-1,-1), 3),
        ("LINEBEFORE",    (0,0),(0,-1),  3, accent),
        ("VALIGN",        (0,0),(-1,-1), "TOP"),
    ])
    inner = Table(data_rows, colWidths=[lw, dw])
    inner.setStyle(inner_ts)

    outer_data = [
        [Paragraph(f"<b>{title}</b>",
                   S("dh",fontSize=10,fontName="Helvetica-Bold",textColor=C_WHITE,leading=13))],
        [Paragraph(mnemonic,
                   S("dm",fontSize=17,fontName="Helvetica-Bold",textColor=C_YELLOW,alignment=TA_CENTER,leading=21))],
        [inner],
    ]
    outer_ts = TableStyle([
        ("BACKGROUND",   (0,0),(-1,-1), C_CARD1),
        ("BACKGROUND",   (0,0),(-1,0),  accent),
        ("BOX",          (0,0),(-1,-1), 1.5, accent),
        ("LEFTPADDING",  (0,0),(-1,-1), 5),
        ("RIGHTPADDING", (0,0),(-1,-1), 5),
        ("TOPPADDING",   (0,0),(-1,-1), 4),
        ("BOTTOMPADDING",(0,0),(-1,-1), 4),
        ("ALIGN",        (0,1),(-1,1),  "CENTER"),
        ("VALIGN",       (0,0),(-1,-1), "TOP"),
    ])
    outer = Table(outer_data, colWidths=[width])
    outer.setStyle(outer_ts)
    return outer

dumb_card = detail_card("💧 Muscarinic Effects", "DUMBELLS",
                         dumbell_rows, C_ACCENT1, 14*mm, 64*mm, 84*mm)
week_card = detail_card("⚡ Nicotinic Effects", "Days of the Week",
                         weekday_rows, colors.HexColor("#FFCA28"), 14*mm, 64*mm, 84*mm)

chol_row = Table([[dumb_card, week_card]], colWidths=[86*mm, 86*mm])
chol_row.setStyle(TableStyle([
    ("LEFTPADDING",  (0,0),(-1,-1), 2),
    ("RIGHTPADDING", (0,0),(-1,-1), 2),
    ("TOPPADDING",   (0,0),(-1,-1), 0),
    ("BOTTOMPADDING",(0,0),(-1,-1), 0),
    ("VALIGN",       (0,0),(-1,-1), "TOP"),
]))
story.append(chol_row)
story.append(Spacer(1, 5*mm))

# ── ANTICHOLINERGIC POEM ──────────────────────────────────────────────────
story.append(header_banner("🌵 ANTICHOLINERGIC — Classic Poem", C_ACCENT2))
poem_lines = [
    "🦇  <b>Blind as a bat</b>  (mydriasis, blurred vision)",
    "🎩  <b>Mad as a hatter</b>  (agitation, delirium, hallucinations)",
    "🌹  <b>Red as a beet</b>  (flushed skin, peripheral vasodilation)",
    "🔥  <b>Hot as Hades</b>  (hyperthermia — anhidrosis = can't sweat)",
    "🏜  <b>Dry as a bone</b>  (dry mouth, no secretions)",
    "💙  <b>The bowel and bladder lose their tone, and the heart runs alone</b>",
    "      (urinary retention, constipation, tachycardia)",
]
alt_lines = [
    "Can't See  ·  Can't Pee  ·  Can't Spit  ·  Can't Shit",
]

poem_data = [[Paragraph(line, S("pl3",fontSize=9,fontName="Helvetica",textColor=C_LIGHT,leading=14))]
             for line in poem_lines]
poem_data.append([Paragraph(alt_lines[0],
                             S("alt",fontSize=10,fontName="Helvetica-Bold",textColor=C_YELLOW,
                               alignment=TA_CENTER, leading=14))])
poem_ts = TableStyle([
    ("BACKGROUND",   (0,0),(-1,-1), C_CARD1),
    ("BOX",          (0,0),(-1,-1), 1.5, C_ACCENT2),
    ("LINEABOVE",    (0,-1),(-1,-1), 1, C_ACCENT2),
    ("LEFTPADDING",  (0,0),(-1,-1), 12),
    ("RIGHTPADDING", (0,0),(-1,-1), 12),
    ("TOPPADDING",   (0,0),(-1,-1), 4),
    ("BOTTOMPADDING",(0,0),(-1,-1), 4),
    ("BACKGROUND",   (0,-1),(-1,-1), colors.HexColor("#3B1A0A")),
    ("ALIGN",        (0,-1),(-1,-1), "CENTER"),
])
poem_table = Table(poem_data, colWidths=[168*mm])
poem_table.setStyle(poem_ts)
story.append(poem_table)

# ── Build ─────────────────────────────────────────────────────────────────
doc.build(story, onFirstPage=on_page, onLaterPages=on_page)
print(f"PDF saved to: {OUTPUT}")

Running Command

cd /tmp/workspace/toxidrome-flashcards && python generate_pdf.py 2>&1

Your PDF is ready! Here's what's included across 2 pages:

Toxidrome Mnemonics Flashcard
PDF Document · PDF

What's inside:

Page 1 - Symptom-Based Mnemonics:

🫀 BRADYCARDIA - PACED (Beta-blockers, Opiates, Clonidine, Ethanol, Digoxin)
💓 TACHYCARDIA - FAST (Cocaine, Anticholinergics, Sympathomimetics, Theophylline)
👁 MIOSIS - COPS (Cholinergics, Opioids, Phenothiazines, Sedatives)
👁 MYDRIASIS - SAW (Sympathomimetics, Anticholinergics, Withdrawal)
⚡ SEIZURES - OTIS CAMPBELL (12 toxin classes, 3-column layout)
💤 COMA - LETHARGIC (9 toxin classes)
🩸 DIALYZABLE TOXINS - PLASMA TV

Page 2 - Toxidrome Comparison + Detail:

Full comparison table of all 5 toxidromes (HR, BP, Pupils, Skin, Key clue)
Cholinergic detail: DUMBELLS (muscarinic) + Days of the Week (nicotinic)
Anticholinergic poem: "Blind as a bat, Mad as a hatter..." + "Can't See, Can't Pee, Can't Spit, Can't Shit"

All on a dark navy background with colour-coded accent cards per mnemonic - easy to read at a glance.

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