Cholinergic toxicity is characterized by which set of symptoms abbreviated as SLUDGE?

• A. Salivation, Lacrimation, Urination, Defecation, GI distress, Emesis
• B. Sweating and dehydration
• C. Confusion and agitation with hypertension
• D. Cramping and diarrhea without salivation

Answer: (A)

Cholinergic toxicity is driven by overstimulation of muscarinic receptors, which increases glandular secretions and smooth muscle activity. The SLUDGE mnemonic captures the classic muscarinic signs: Salivation, Lacrimation, Urination, Defecation, GI distress, and Emesis. So the most characteristic cluster includes drooling, tearing, frequent urination, diarrhea or abdominal cramps, and vomiting. That’s why the option listing those six elements is the best match. Other choices describe symptoms that aren’t the hallmark of this muscarinic overdrive—sweating and dehydration aren’t part of SLUDGE, confusion with hypertension points to different pathways, and cramping with diarrhea without salivation misses the salivation and lacrimation components central to the picture.