The organophosphate parathion

A 32-year-old man is brought to the emergency department because of confusion, wheezing, vomiting, and diarrhea for the past 6 hours. He is sweating and salivating profusely. There is generalized muscle weakness. Which of the following substances is the most likely cause of these findings?
Glutethimide
Heroin
Jimson weed (belladonna alkaloids)
Parathion
Phencyclidine (PCP)
Correct answer
Parathion
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correct answer: D
This patient has been poisoned by the organophosphate parathion. Organophosphates inhibit acetylcholinesterase (AChE), leading to toxic build-up of acetylcholine (ACh) and resulting in the symptoms listed above. Remember the mnemonic DUMBELS associated with cholinergic toxicity: Defecatioin, Urination, Miosis, Bronchorrhea/Bronchospasm/Bradycardia, Emesis, Lacrimation, Salivation.