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Cholinergic Toxicity

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Cholinergic Toxicity, Cholinergic Overdose, Parasympathomimetic Poisoning, Cholinergic

  • See Also
  1. Parasympathetic System
  2. Cholinergic Agonist
  3. Organophosphate
  4. Organophosphate Poisoning Management
  5. Parasympathetic Nervous System
  6. Anticholinergic Medication
  7. Anticholinergic Toxicity
  • Causes
  1. See Organophosphate Poisoning
  2. See Nerve Agent Exposure
  1. Cardiopulmonary
    1. Bradycardia
    2. Bronchospasm
    3. Bronchorrhea
    4. Vasopressor resistant Hypotension
    5. Aspiration Pneumonitis
  2. Neurologic
    1. Miosis
    2. Anxiety or Agitation
    3. Lethargy or coma
    4. Acute Respiratory Failure (Bellows Failure from loss of respiratory drive)
    5. Muscle Fasciculations
    6. Flaccid Paralysis (including respiratory Muscles)
    7. Seizures (uncommon)
  3. Sludge
    1. Salivation
    2. Lacrimation
    3. Urination
    4. Diarrhea (and Diaphoresis)
    5. Gastrointestinal cramping
    6. Emesis (Nausea and Vomiting)
  • Findings
  • Mnemonic - SLUDgE + Killer Bs, or DUMBELLS
  1. Sludge
    1. Salivation
    2. Lacrimation
    3. Urination
    4. Diarrhea (and Diaphoresis)
    5. Gastrointestinal cramping
    6. 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)
  • Diagnostics
  1. Electrocardiogram
  • Management
  1. See Nerve Agent Exposure