What are the muscarinic symptoms of organophosphate (OP) toxicity?

Updated: Dec 31, 2020
  • Author: Kenneth D Katz, MD, FAAEM, ABMT; Chief Editor: Sage W Wiener, MD  more...
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Mnemonic devices used to remember the muscarinic effects of organophosphates are SLUDGE (salivation, lacrimation, urination, diarrhea, GI upset, emesis) and DUMBELS (diaphoresis and diarrhea; urination; miosis; bradycardia, bronchospasm, bronchorrhea; emesis; excess lacrimation; and salivation). Muscarinic effects by organ system include the following:

  • Cardiovascular - Bradycardia, hypotension
  • Respiratory - Rhinorrhea, bronchorrhea, bronchospasm, cough, severe respiratory distress
  • Gastrointestinal - Hypersalivation, nausea and vomiting, abdominal pain, diarrhea, fecal incontinence
  • Genitourinary - Incontinence
  • Ocular - Blurred vision, miosis
  • Glands - Increased lacrimation, diaphoresis

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