Jones & Bartlett Learning (JBL) Module 6 Practice Exam

Organophosphate exposure blocks acetylcholinesterase, so acetylcholine builds up at both muscarinic and nicotinic receptors. The muscarinic effects drive the classic cholinergic overactivation, including increased secretions such as salivation (along with lacrimation, sweating, bronchorrhea, bronchospasm, miosis, and GI/urinary changes). Excessive salivation is the most recognizable sign of this muscarinic overstimulation. Pupil dilation would be unlikely because muscarinic activity causes pupil constriction (miosis). Urinary retention would not typical of the cholinergic surge, as these effects promote bladder contraction and urination. Tremors can occur from nicotinic receptor stimulation, but they’re not as representative of the overall cholinergic overdrive as excessive salivation.