Cholinergics include organophosphates, carbamates, pilocarpine, and in some mushrooms. Mostly farmers and other industrial workers. Manifestations are cholinergic including nausea, sweating, diarrhea, salivation, headache, fatigue, convulsions, muscle weakness, and cardiovascular collapse. Sweating, constricted pupils, lacrimation, salivation, diarrhea, incontinence. Striated muscle problems including fasciculations, collapse.
Death usually occurs from respiratory muscle depression and excessive secretions or bronchospasm.
Decontaminate GI tract if needed including lavage and multiple-dose charcoal. Watch for ileus secondary to atropine. Atropine 2 mg IV every 15 to 20 minutes using the drying of secretions or evidence of toxicity as an end point. Atropine will treat the muscarinic effects only. Can repeat in 1 to 2 hours.