Cholinergic Toxicity

Aka: Cholinergic Toxicity, Cholinergic Overdose, Parasympathomimetic Poisoning, Cholinergic

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II. Causes

  1. See Organophosphate Poisoning
  2. See Nerve Agent Exposure

III. Findings: Symptoms and Signs (Mnemonic: SLUDgE + Killer Bs, or DUMBELLS)

  1. Sludge
    1. Salivation
    2. Lacrimation and Lethargy
    3. Urination
    4. Diarrhea (and Diaphoresis) and abdominal cramping
    5. Emesis (Nausea and Vomiting)
  2. Killer B's
    1. Bronchospasm
    2. Bronchorrhea
    3. Bradycardia (muscarinic)
      1. Tachycardia may occur with nicotinic toxicity
  3. Other
    1. Miosis (pinpoint pupils)

IV. Findings: Symptoms and Signs: Other (not covered by mnemonic)

  1. Anxiety or Agitation
  2. Seizures
  3. Coma
  4. Muscle Fasciculations
  5. Flaccid Paralysis (including respiratory Muscles)

V. Diagnostics

  1. Electrocardiogram

VI. Management

  1. See Nerve Agent Exposure

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