Cholinergic crisis (mnemonic)

Last revised by Dr Daniel J Bell on 12 Jul 2022

Mnemonics for clinical findings relating to cholinergic crisis comprise:

  • MDS​' BEDBUG LB
  • FW HRCT
  • CDS' CASA

Mnemonics

MDS' BEDBUG LB

Colloquially denoting "MDs' Bedbug Pound," with pound semantically signaled by the letters "Lb", this mnemonic corresponds to the clinical features of acute cholinergic toxicity, relating to the stimulation of muscarinic receptors and which are consistent with cholinergic excess manifestations that include 1,2:

  • M: miosis
  • D: diaphoresis 
  • S: salivation
  • B: bronchorrhea
  • E: emesis/vomiting
  • D: defecation/diarrhea
  • B: bronchospasm
  • U: urination
  • G: gastrointestinal cramping and pain
  • L: lacrimation
  • B: bradycardia
FW HRCT 

In contrast, based on a mnemonic colloquially signifying "ForWarded High-Res CT," the clinical features corresponding to the stimulation of nicotinic receptors encompass 3:

  • F: fasciculation (of muscles)
  • W: weakness (of muscles)
  • H: hypertension
  • R: respiratory paralysis/depression
  • C: cramping (of muscles)
  • T: tachycardia 
CDS' CASA

Lastly, employing a mnemonic device denoting "A Home for CDs" when translated into English, the central nervous system (CNS) effects relating to a cholinergic crisis consist of 4:

  • C: confusion
  • D: delirium/altered mental status
  • S: seizures/convulsions
  • C: coma
  • A: ataxia
  • S: slurred speech
  • A: agitation/restlessness

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