A 22-year-old female veterinary student who ingested tick killer shows signs of SLUDGE. What medication does she need?

The presence of SLUDGE symptoms, which stands for Salivation, Lacrimation, Urination, Diarrhea, Gastrointestinal distress, and Emesis, suggests that the individual is experiencing a cholinergic crisis, often associated with exposure to insecticides like tick killers that may contain organophosphates or carbamates.

Atropine is an anticholinergic medication that works by blocking the effects of acetylcholine at muscarinic receptors. By doing so, it can alleviate the SLUDGE symptoms by reducing salivation, lacrimation, and gastrointestinal activity, thus addressing the cholinergic overactivity. The use of atropine in this scenario is well-established in clinical practice for managing organophosphate poisoning, making it the appropriate medication in this context.

While activated charcoal is often used in cases of poisoning to absorb toxic substances in the gastrointestinal tract, it does not specifically counteract the life-threatening symptoms associated with cholinergic toxicity. Flumazenil is a benzodiazepine antagonist and is not relevant in the context of SLUDGE, which is primarily due to increased cholinergic activity rather than benzodiazepine effects. Calcium gluconate may be used in certain specific poisoning situations, such as those involving certain