Cholinergic Intoxication

Epidemiology

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Etiology

Cigua Toxin Poisoning (see Cigua Toxin Poisoning, [[Cigua Toxin Poisoning]])

  • Associated Toxin: scaritoxin (which is a ciguatera-associated toxin) -> increases permeability of sodium channels, resulting in norepinephrine and acetylcholine release

Scorpion Envenomation (see Scorpion Sting, [[Scorpion Sting]])

  • Associated Scorpion Species
    • Centuroides Exilicauda (Sculpuratus)
    • Centuroides Suffusus

Toxic Mushrooms (see Toxic Mushrooms, [[Toxic Mushrooms]])

  • Associated Mushrooms
    • Boletus Calopus
    • Clitocybe Dealbata
    • Clitocybe Illudens
    • Inocybe Fastigiata
  • Toxin(s)
    • Muscarine: acts at muscarinic receptors in autonomic nervous system

Other

  • Carbamate Intoxication (see Carbamates, [[Carbamates]])
  • Organophosphate Intoxication (see Organophosphates, [[Organophosphates]])

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Diagnosis

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Clinical (SLUDGE+NC)

  • Salivation (see Hypersalivation, [[Hypersalivation]])
  • Lacrimation (see Lacrimation, [[Lacrimation]])
  • Urination
  • Diarrhea (see xxxx, [[xxxx]])
  • Gastrointestinal Cramps (see Abdominal Pain, [[Abdominal Pain]])
  • Emesis (see xxxx, [[xxxx]])
  • Neurologic
    • Fasciculations (see Fasciculations, [[Fasciculations]])
    • Muscle Weakness
  • Cardiac
    • Early
      • Hypertension
      • Sinus Tachycardia
    • Later
      • Sinus Bradycardia (see xxxx, [[xxxx]])
      • Heart Blocks (see xxxx, [[xxxx]])
      • Hypotension (see xxxx, [[xxxx]])

Treatment

  • Cardiac: atropine (blocks muscarinic effects)
  • Pralidoxime (2-PAM): indicated for organophosphate intoxication

References

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