Cholinergic Toxidrome Details:
- From an occupational & environmental health point of view, the cholinergic toxidrome is the most important syndrome to be aware of.
- The other toxidromes (ie anticholinergic, sympathomimetic, opioid, sedative/hypnotic, hallucinogenic) are most often associated with overdoses of drugs or medications.
- SLUDGE or DUMBELLS are simple mnemonics for the common clinical symptoms (see below).
- Clinical interpretation of this toxidrome can be complicated if multiple agents are involved.
Cholinergic Toxidrome Aetiologic Agents:
- Organophosphate pesticides (ie malathion, diazinon)
- Carbamates (ie physostigmine, carbaryl)
- Mushrooms (certain types)
- Sarin (warfare agent)
Cholinergic Toxidrome Pathophysiology:
- The underlying mechanism is excessive cholinergic (acetylcholine) receptor stimulation.
- There are various classes of cholinergic receptors (see table) that can be stimulated in this toxidrome.
- The symptoms induced depend on the relative stimulation of the different receptors.
- Common clinical features can be remembered by the mnemonics SLUDGE or DUMBELLS syndrome.
SLUDGE Syndrome:
- S - Salivation
- L - Lacrimation
- U - Urination
- D - Diarrhoea
- G - Gastrointestinal distress
- E - Emesis
DUMBELLS Syndrome:
- D - Diarrhoea
- U - Urination
- M - Miosis (small pupils)
- B - Bradycardia
- E - Emesis
- L - Lacrimation
- L - Lethargy
- S - Salivation
Tags: Acetylcholine - Carbaryl - Cholinergic Toxidrome - Diazinon - DUMBELLS - Malathion - Muscarinic Receptor - Nicotinic Receptor - Organophosphate Pesticide - Physostigmine - Sarin - SLUDGE Syndrome - Toxidrome
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Medicalchemy Group: History of Medicine - Images - Mnemonics - Syndromes - Acute Medicine - Anaesthesiology - Anatomy - Anthropology - Biochemistry - Cardiology - Dentistry - Dermatology - Drug ADR - Drugs - Embryology - Emergency Medicine - Endocrinology - Epidemiology - Family Medicine - Forensic Medicine - Gastroenterology - Genes - Genetics - Geriatrics - Gynecology - Haematology - Health Informatics - Hepatology - Immunology - Infection - Intensive Care - Medical Dictionary - Medical Education - Medical Statistics - Metabolic Medicine - Microbiology - Nephrology - Neuroanatomy - Neuroscience - Nuclear Medicine - Nutrition - Obstetrics - Occupational Health - Oncology - Ophthalmology - Orthopaedics - Otolaryngology - Paediatrics - Palliative Care - Parasitology - Pathology - Pharmacology - Physiology - Proteomics - Psychiatry - Public Health - Radiology - Respiratory - Rehabilitation - Rheumatology - Sports Medicine - Surgery - Toxicology - Tropical Medicine - Urology - Vascular - Virology.
