What happens if you have too much ACh?

Excessive accumulation of acetylcholine (ACh) at the neuromuscular junctions and synapses causes symptoms of both muscarinic and nicotinic toxicity. These include cramps, increased salivation, lacrimation, muscular weakness, paralysis, muscular fasciculation, diarrhea, and blurry vision.

What are the clinical features of organophosphorus poisoning?

The typical toxidrome in organophosphate (OP) poisoning comprises of the Salivation, Lacrimation, Urination, Defecation, Gastric cramps, Emesis (SLUDGE) symptoms.

How organophosphate affect cholinergic pathway?

Organophosphates are anti-esterase insecticides, and exert their acute effects by causing overstimulation at cholinergic nerve terminals. This process occurs in both insects and humans. Normally, acetylcholinesterase catalyzes the degradation of the neurotransmitter acetylcholine in the synapse (yellow panel below).

How does atropine help organophosphate toxicity?

Atropine is administered intravenously to restore adequate cardiorespiratory function rapidly – a process often termed ‘atropinzation’. It is used to reverse bradycardia and improve systolic blood pressure to greater than 80 mmHg.

What is muscarinic action?

Muscarinic agonists mimic the action of acetylcholine on muscarinic receptors and cause cardiac slowing, contraction of smooth muscles (intestinal tract, bronchioles, detrusor muscle, urethra, and iris muscle), and increased secretion from exocrine glandular tissues (salivary, gastric acid, and airway mucosal gland).

How does excess acetylcholine cause muscle weakness?

Activation of muscarinic receptors in the eye by excess acetylcholine will produce miosis and blurry vision. Increased acetylcholine at nicotinic sites at the neuromuscular junction causes muscle fasciculations and flaccid paralysis due to excess acetylcholine at the neuromuscular junction.

How does the body respond to large doses of cholinergic drugs?

cholinergic drug, any of various drugs that inhibit, enhance, or mimic the action of the neurotransmitter acetylcholine, the primary transmitter of nerve impulses within the parasympathetic nervous system—i.e., that part of the autonomic nervous system that contracts smooth muscles, dilates blood vessels, increases …

Are muscarinic receptors sympathetic or parasympathetic?

Muscarinic receptors are G-coupled protein receptors involved in the parasympathetic nervous system. The only exception to these receptors is the sweat glands, which possess muscarinic receptors but are part of the sympathetic nervous system.

What are muscarinic symptoms?

Part 4: The Cholinergic Toxidrome

End Organ Effected Parasympathetic (Muscarinic) Effects
Eyes blurred vision (especially, difficulty focusing on near objects) conjunctival injection dimness of vision miosis (pupillary constriction)
Gastrointestinal tract cramping diarrhea incontinence nausea vomiting

Why do organophosphates constrict pupils?

Stimulation of the α-adrenergic receptors located on the radial muscles of the iris will result in dilation of the pupil (Yu, 2002, 2003), while stimulation of the muscarinic receptors of the pupillary sphincter will result in constriction of the pupil (Furuta etal., 1998; Smith etal., 1996).