A patient present to emergency with pinpoint pupil, salivation, lacrimation, tremors and red tears. Plasma cholinesterase level was 30% of normal . Most probable diagnosis is
Refer katzung 12e p110 These are characteristic feature of anticholinesterase(organophosphorous and carbamates) poisoning features of organophosphate poisoning muscarinic symptoms: pinpoint pupil, salivation, lacrimation ,urination,defecation,gastrointestinal distress, vomiting, bronchospasm, bradycardia nicotinic symptoms: fasciculations and fibrillation of muscle, tachycardia and tachypnea CNS symptoms :Tremors, giddiness, ataxia and coma red tears: due to accumulation ofporphyrin in the lacrimal glands
Organophosphate poisoning
Datura poisoning
Opioid poisoning
Pontine haemorrhage
Autonomic nervous system