A cholinergic crisis may be triggered by a number of drugs or chemicals that result in an accumulation of acetylcholine at neuromuscular junctions.
Clinical features:
(1) severe muscarinic features with copious secretions within the airways
(2) severe nicotinic features including tachycardia and hypertension
(3) seizures
(4) coma
(5) respiratory arrest
(6) hemodynamic instability
Distinction from a myasthenic crisis: 2 mg of edrophonium will worsen symptoms in a cholinergic crisis but improve symptoms in a myasthenic crisis.
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Specialty: Emergency Medicine, Toxicology
