Cholinergic and Anticholinergic Toxicity (Toxidrome)

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[@mumbos8211]

The funny thing is, its thought that anticholinergic substances were actually thought to be involved in the writing of Alice in wonderland. A mushroom known as aminita muscaria with gabaurgic and anticholinergic effects was likely consumed by the author of the book, being a big source of inspiration in its writing

[@dilashmathapa5791]

These mnemonics are very helpful, thanks.

[@cascarney5856]

I love you videos, this one is great as always! But shouldn't it be "salivation" instead of "salvation" in SLUDGE?

[@AlejandraGutierrez-ns3xg]

That’s what I said. Yes. I hope everyone else can make the correct assumption lol.

[@gabogalaiz]

This is why i follow you, you're the maaan

[@rahelruegg3091]

Great video! Short and concise.

[@IxDarkxNinjaxI]

Nice video. I survived anticholinergic toxicity, neuroleptic malignant syndrome and severe antipsychotic withdrawal symptons all at the same time.

[@prem9185]

Wow

[@gabytemp7408]

How did you manage to survive the anticholinergic toxicity. I have it currently & it's hell......

[@tlee5588]

What is the difference between muscarinic cholinergic vs. nicotinic cholinergic toxidromes?

[@HamCubes]

I wanna be the very best, Like no one ever was!

[@rishikwatt483]

What. Wait…

[@Saffron-sugar]

Anticholinergic used to be the “horror movie“ toxidrome: red as blood, mad as a hatter, dry as a bone, blind as a bat (dilated pupils), hot as hell . Anticholinergic toxidrome has certainly changed since I was in medical school. They used to say “hot as hell“ but that seems to have been changed to “hot as a hare”. But why is a hare hot? The full urinary retention is new to me. But great to mention! Especially in comparison to Cholinergic poisoning.

[@BBCeiz1993]

Mr Armando can you give to them lectures about arrhythmia there is a difficulty in understanding this object

[@guibyalknosee234]

Is a chronical cholinergic crisis a possible thing? I'm asking because after just three doses of choline alfoscerate at 400 mg, I developed a bunch of torturous symptoms. For more than six weeks I have been constantly in a depressed, anxious, desperate mood. I have no appetite at all (I hardly can eat), I have ringing in the ears, bradycardia, thready pulse, impaired circulation, increased intestinal peristalsis, fatigue, chills, sweating, slight fever, weakness and other crazy parasympathetic effects. Is it theoretically possible that, for some unknown reason, my acetylcholine level does not decrease and even gradually accumulates, which leads to such symptoms? This hypothesis came to my mind for the following reasons: 1) The antidepressants prescribed to me only affect my mood but have no effect on the "muscarinic" symptoms, like bradycardia. It looks like a mood disorder is one of the manifestations of the disease, and not the disease itself. 2) Atropine temporarily relieves my condition 3) A dose not exceeding 1 mg of atropine does not even raise my pulse 4) Over time, the effectiveness of atropine decreases. Since I use it only in extreme cases, my body's adaptation to it is doubtful. 5) If acetylcholine does not accumulate in my body, then the disease would go away by itself, since cholinesterase would quickly remove excess acetylcholine So how to reduce the level of acetylcholine in my body or, if this is not possible, how to block excess acetylcholine? What medications are best for this?

[@Avrilbk]

You are saving my college years

[@hmne1]

did you finished the college

[@StevePhillips]

Brilliant ways to remember thank you man!!!

[@xianblackk]

...Pokemon... I love you

[@luisasalomon7424]

I love all this videos, thanks.

[@shandranorman4710]

Thank you!!

[@beckiehodel7009]

This is amazing😩🙏

[@Romeo14146]

Sir plz make a video with adrenergic and cholinergic pharmacology....

[@sc7836]

I have been trying to understand better why I had mental health crisises immediately after herbicide exposure. It seems like I was a mix of the sludge monster and alice... Can you explain why it might have been that I went to both extremes? ( I am a long time nicotine user which I think might play a role. Also curious if some ancestries have more muscarinic receptors than others?)

[@mackes3683]

Thanks !

[@ufoguy]

I loved the pokemon reference

[@raided2345]

Salivation👅 rather, not salvation⛪

[@joshuasamsoondar]

noticed this too, cholinergics will save you from your sins ahah

[@alzulaimani6847]

𝓯𝓻𝓮𝓪𝓴𝔂 👅

[@rishikwatt483]

Pokémon? What is that? I mean, come on.

[@mehakkhan4758]

awesome

[@MrEthanhines]

How can something that activates the Parasympathtic Nervous System (the one used for relaxing) cause death as in Sarin....?!

+MrEthanhines Sarin and Parathion are organophosphates that irreversibly inactivate acetylcholinesterase (enzyme responsible for degrading acetylcholine in the synaptic cleft). This leads to an excess of acetylcholine in the nerves. Death may occur from impairment of respiratory muscle, arrhythmias and cardiac failure for example.

[@MrEthanhines]

Andre Fernandes yes but i thought blocking acetylcholine esterase was important for memory in patients with Alzheimers? So essentially these organophosphates kill by over relaxing the person (brady cardia/pnea) zero muscle tone, incontinence, salivation and tears?

[@mylinhnguyen6389]

+MrEthanhines AchE inhibitors used to treat Alzheimer’s disease are reversible inhibitors. This means that it will prevent AchE from breaking down Ach for a period of time, but AchE will eventually be regenerated to break down Ach. Sarin, as mentioned above, is an organophosphate that is an irreversible AchE inhibitor. This means that AchE will never be regenerated, resulting in Ach toxicity. Remember, Ach is non-selective and can bind to both muscarinic and nicotinic receptors. Initially, Ach binding to muscarinic receptors will result in the “SLUDGE BBB” effects as mentioned above in this video. Thereafter, Ach will start binding to central and peripheral nicotinic receptors, resulting in convulsions/coma and paralysis, respectively. Excessive Ach binding and activation may (in most cases will) result in death.

[@johnathanabrams8434]

@@mylinhnguyen6389 your comment was from 6 years ago. Has anything changed in regard to reactivating acetylcholinesterase ?