A patient present to emergency with pinpoint pupil, salivation, lacrimation, tremors and red tears. Plasma cholinesterase level was 30% of normal . Most probable diagnosis is
Organophosphate poisoning
Datura poisoning
Opioid poisoning
Pontine haemorrhage
Refer katzung 12e p110 These are characteristic feature of anticholinesterase(organophosphorous and carbamates) poisoning features of organophosphate poisoning muscarinic symptoms: pinpoint pupil, salivation, lacrimation ,urination,defecation,gastrointestinal distress, vomiting, bronchospasm, bradycardia nicotinic symptoms: fasciculations and fibrillation of muscle, tachycardia and tachypnea CNS symptoms :Tremors, giddiness, ataxia and coma red tears: due to accumulation ofporphyrin in the lacrimal glands
Autonomic nervous system