35 year old man was found unconscious. Examination revealed bilateral constricted pupil, bradycardia, excessive sweating and secretion. most likely causes
Refer kDT 7/e p 110,111 Signs and Symptoms Muscarinic signs (SLUDGE) salivation, lacrimation, urination, diaphoresis, gastrointestinal upset, emesis and progressing to bronchospasm, bronchorrhea, blurred vision, bradycardia or tachycardia, hypotension, confusion, and shock. Nicotinic effects Skeletal muscle initially exhibits fasciculation (involuntary irregular, violent muscle contractions) followed by the inability to repolarize cell membranes resulting in weakness and paralysis. Severe reactions can lead to ventilatory failure and death (cholinergic crisis).
Opium poisoning
Acute alcohol intoxication
Organophosphorus poisoning
Pontine haemorrhage
Autonomic nervous system