Study note
PharmacologyCHOLINERGIC TRANSMISSION & CHOLINERGIC DRUGS

Clinical manifestations of anticholinesterase poisoning

THE CONTEXT
Anticholinesterase poisoning produces secretory, ocular, respiratory, cardiovascular, muscular and central manifestations.

Secretory, ocular and visceral findings

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Eye irritation, lacrimation, salivation, copious tracheobronchial secretions, miosis and blurred vision may occur.
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Other findings include bronchospasm, breathlessness, colic, involuntary defecation and involuntary urination.

Cardiovascular and muscular findings

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Blood pressure may fall, and either bradycardia or tachycardia may occur. Cardiac arrhythmias and vascular collapse are also described.
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Muscular fasciculations and weakness may progress to respiratory paralysis, which has both central and peripheral components.

Central findings and fatal outcome

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Central manifestations include irritability, disorientation, unsteadiness, tremor, ataxia, convulsions and coma.
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Death is generally due to respiratory failure.
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