Neuromuscular junction over-stimulation due to an excess of acetylcholine (ACh), as of a result of the inhibition of the AChE enzyme (which normally breaks down acetylcholine)
The neuromuscular junction, where the brain communicates with muscles (e.g. the diaphragm), works by acetylcholine activating nicotinic acetylcholine receptors and leading to muscle contraction.
Atropine blocks muscarinic acetylcholine receptors (a different subtype than the nicotinic receptors at the neuromuscular junction), so will not improve the muscle strength and ability to breathe.
So, such patients will frequently require mechanical ventilation until the<unk>  resolves. There is not specific antidote for the respiratory compromise.
So, such patients will frequently require mechanical ventilation until the<unk>  resolves. There is not specific antidote for the respiratory compromise.
Parasympathetic - ACh is transm
Muscarinic
receptors in heart, eye, lung, GI, skin and sweat glands
Bradycardia
Miosis
Bronchorrhea / Bronchospasm
Hyperperistalsis (SLUDGE)
Sweating
Vasodilation
Nicotinic
receptors in both sympathetic and parasympathetic nervous systems
fasciculations, flaccid paralysis
?Mild bradycardia, hypotension
Sympathetic
Alpha effects (vessels, eye, skin)
Mydriasis, hypertension, sweating
Beta effects (heart, lungs)
Tachycardia, bronchodilation
Muscarinic
receptors in heart, eye, lung, GI, skin and sweat glands
Bradycardia
Miosis
Bronchorrhea / Bronchospasm
Hyperperistalsis (SLUDGE)
Sweating
Vasodilation
Nicotinic
receptors in both sympathetic and parasympathetic nervous systems
fasciculations, flaccid paralysis
?Mild bradycardia, hypotension
receptors in heart, eye, lung, GI, skin and sweat glands
Bradycardia
Miosis
Bronchorrhea / Bronchospasm
Hyperperistalsis (SLUDGE)
Sweating
Vasodilation
receptors in both sympathetic and parasympathetic nervous systems
fasciculations, flaccid paralysis
?Mild bradycardia, hypotension
Alpha effects (vessels, eye, skin)
Mydriasis, hypertension, sweating
Beta effects (heart, lungs)
Tachycardia, bronchodilation
Mydriasis, hypertension, sweating
Tachycardia, bronchodilation
Cholinergic crisis
Carbamate toxicity
Heat stroke
Mushroom toxicity, especially:
Neurogenic shock
Amanita muscaria
Serotonin syndrome
Inocybe