Which of the following is a symptom included in the SLUDGE mnemonic for organophosphate poisoning?

• A. Lacrimation
• B. Tachycardia
• C. Hyperglycemia
• D. Rash

Answer: (A)

Organophosphate poisoning causes excess acetylcholine at muscarinic receptors, leading to a cholinergic syndrome captured by SLUDGE: Salivation, Lacrimation, Urination, Defecation, Gastrointestinal distress, Emesis. Lacrimation (tearing) is a classic part of this pattern, so it fits perfectly. Tachycardia is not a SLUDGE symptom—it’s more variable and muscarinic effects often produce bradycardia. Hyperglycemia and rash aren’t part of the SLUDGE picture and don’t reflect the typical muscarinic overstimulation seen with organophosphate exposure.