Florida State Paramedic Practice Exam

What is the primary cause of SLUDGE symptoms in cases of poisoning?

1. Heavy metal exposure

2. Organophosphate toxicity

3. Drug overdose

4. Environmental toxins

The correct answer is: Organophosphate toxicity

The presence of SLUDGE symptoms, which include salivation, lacrimation, urination, diarrhea, gastrointestinal distress, and emesis, is primarily associated with organophosphate toxicity. Organophosphates are a class of chemicals commonly found in pesticides and certain nerve agents. They work by inhibiting the enzyme acetylcholinesterase, which is responsible for breaking down acetylcholine in the body. When this enzyme is inhibited, acetylcholine accumulates at synapses, leading to excessive stimulation of both muscarinic and nicotinic receptors. The overstimulation of muscarinic receptors results in the classic SLUDGE symptoms. While other substances can cause similar symptoms, organophosphate poisoning is the most well-recognized and significant cause in the context of SLUDGE. Heavy metals can cause various neurological and systemic effects, drug overdoses may lead to a range of symptoms depending on the substance, and environmental toxins can have diverse impacts but do not specifically cause SLUDGE symptoms in the same way organophosphate toxicity does.