Clinical Mnemonics · Pharmacology & Electrolytes
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Names the classic muscarinic effects of cholinergic excess — Salivation, Lacrimation, Urination, Defecation/Diarrhea, Gastrointestinal distress, Emesis — the 'wet patient' of organophosphate/carbamate poisoning and nerve-agent exposure.
The college version
Names the classic muscarinic effects of cholinergic excess — Salivation, Lacrimation, Urination, Defecation/Diarrhea, Gastrointestinal distress, Emesis — the 'wet patient' of organophosphate/carbamate poisoning and nerve-agent exposure.
S — Salivation
Excess saliva, drooling, frothing
Muscarinic (M3) stimulation of salivary glands produces copious salivation, drooling, and frothing — a visible early sign of organophosphate or nerve-agent poisoning.
Physiology. Acetylcholine normally drives salivation via M3 muscarinic receptors; when acetylcholinesterase is inhibited, acetylcholine accumulates and the glands run at full blast.
L — Lacrimation
Excess tears
Muscarinic stimulation of the lacrimal glands causes excess tearing; with miosis it is a hallmark of cholinergic toxicity.
Physiology. Lacrimal glands, like salivary glands, are M3 muscarinic targets driven by acetylcholine excess.
U — Urination
Involuntary / increased urination
Muscarinic stimulation of the detrusor causes involuntary urination and urgency — part of the 'wet patient' picture.
Physiology. Bladder contraction is mediated by M3 receptors on the detrusor; acetylcholine excess causes uncontrolled emptying.
D — Defecation / Diarrhea
Involuntary stool, diarrhea
Cholinergic excess produces gastrointestinal hypermotility with diarrhea and involuntary defecation.
Physiology. M3 receptors increase gut smooth-muscle motility and secretions; acetylcholine excess causes cramping and diarrhea.
G — Gastrointestinal distress
Cramping, hypermotility
Smooth-muscle hypermotility causes abdominal cramping, nausea, and increased GI secretions, worsening dehydration and electrolyte loss.
Physiology. The same muscarinic overdrive that causes diarrhea also produces cramping and secretory losses.
E — Emesis
Vomiting
Muscarinic stimulation plus central chemoreceptor activation triggers vomiting, adding to fluid loss and raising aspiration risk in a patient with a compromised airway.
Physiology. Acetylcholine excess activates peripheral GI receptors and central pathways that coordinate vomiting.
Memory aids
- S = Salivation
- L = Lacrimation
- U = Urination
- D = Defecation / Diarrhea
- G = Gastrointestinal distress
- E = Emesis
Quick review
- S = Salivation — Excess saliva, drooling, frothing
- L = Lacrimation — Excess tears
- U = Urination — Involuntary / increased urination
- D = Defecation / Diarrhea — Involuntary stool, diarrhea
- G = Gastrointestinal distress — Cramping, hypermotility
- E = Emesis — Vomiting
Eli explains
The same idea, in plain words
Explain it like I’m 10
A list of the 'wet and leaky' signs that happen when too much acetylcholine turns on all the body's squeeze-and-secrete switches at once.
S — Salivation. The mouth has 'water faucets' that a chemical messenger turns on. Too much messenger leaves the faucets stuck open, so the mouth overflows with spit.
L — Lacrimation. The same messenger turns on the tear faucets, so the eyes water even though the patient isn't sad.
U — Urination. The bladder is told to squeeze and empty by the same messenger; too much makes it squeeze on its own, so the patient wets themselves.
D — Defecation / Diarrhea. The gut is told to squeeze and push by this messenger; too much makes the bowels move too much — loose, watery, uncontrollable stool.
G — Gastrointestinal distress. The stomach and intestines cramp and churn too hard, like a washing machine stuck on spin — painful belly cramps and nausea.
E — Emesis. The stomach gets the 'throw up' signal too, so the patient vomits, sometimes repeatedly.
Study toolsKey vocabulary
Key vocabulary
- S
- Salivation
- L
- Lacrimation
- U
- Urination
- D
- Defecation / Diarrhea
- G
- Gastrointestinal distress
- E
- Emesis
Sources & references
This lesson was adapted from the open educational references above; their licenses and attributions are preserved. See Copyright & Licensing.
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