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Cholinergic Toxicity

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Cholinergic Toxicity, Cholinergic Overdose, Cholinergic, Cholinergic Agent, Cholinomimetic, Parasympathomimetic Agent, Parasympathomimetic Poisoning

  • 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)
  • 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)
  • Diagnostics
  • Management