Which toxidrome is associated with SLUDGE symptoms?

• A. Cholinergic Toxidrome
• B. Anticholinergic Toxidrome
• C. Opioid Toxidrome
• D. Sympathomimetic

Answer: (A)

SLUDGE reflects excess muscarinic stimulation from acetylcholine. When acetylcholinesterase is inhibited—such as with organophosphates or nerve agents—acetylcholine builds up at muscarinic receptors in glands and smooth muscle, producing increased secretions and motility. That gives salivation, lacrimation, urination, defecation, GI upset, and vomiting. This pattern is the cholinergic toxidrome. Other toxidromes produce different symptom clusters—anticholinergic causes dry skin and blurred vision with reduced secretions, opioids cause mupil or pinpoint pupils and respiratory depression, and sympathomimetics yield agitation with tachycardia and sweating but not the SLUDGE combination. So SLUDGE is the hallmark of cholinergic toxidrome.