Anticholinergic toxicity presents with which of the following?

• A. Hyperactive bowel sounds, miosis
• B. Hyperthermia, flushed skin, tachycardia
• C. Pupil constriction, salivation
• D. Dry skin, dilated pupils, altered LOC

Answer: (D)

Anticholinergic toxicity results from blocking muscarinic receptors, so parasympathetic effects are diminished. This produces the classic signs: dry skin from reduced sweating, dilated pupils (mydriasis) with potential blurred vision, and altered mental status from CNS effects, often with tachycardia and sometimes hyperthermia. The option that lists dry skin, dilated pupils, and altered level of consciousness lines up with these hallmark features, making it the best choice. Other options show signs of cholinergic activity (such as increased bowel sounds, miosis, or salivation) or mix signs that aren’t as characteristic on their own, so they’re less consistent with anticholinergic toxidrome.