What type of poisoning is characterized by SLUDGE/DUMBBELLS symptoms?

The collection of symptoms known as SLUDGE/DUMBBELLS is indicative of cholinergic poisoning. SLUDGE stands for Salivation, Lacrimation, Urination, Diarrhea, Gastrointestinal distress, and Emesis, while DUMBBELLS expands on these symptoms to include additional details, such as Bradycardia, Bronchorrhea, and Miosis, among others.

Cholinergic poisoning occurs when there is an excessive accumulation of acetylcholine in the body, often due to exposure to certain pesticides or nerve agents that inhibit the enzyme acetylcholinesterase. The result is overstimulation of the parasympathetic nervous system, leading to the characteristic symptoms of increased secretions (salivation and lacrimation), increased gastrointestinal motility (diarrhea and emesis), and respiratory effects (bronchorrhea and bronchospasm), alongside cardiovascular effects like bradycardia.

Understanding the nature of cholinergic poisoning is critical for effective diagnosis and treatment in emergency and critical care settings, making recognition of these symptoms vital for appropriate interventions.