This study post highlights the importance of the 'killer Bs' in cholinergic toxicity. A lot of us already use the 'DUMBELS' mnemonic (diarrhoea, urination, miosis, bradycardia, bronchospasm, bronchial secretions, emesis, lacrimations and sweating) to remember the side effect of cholinergic drugs.

The 'killer Bs' describe the life threatening signs and symptoms of patients presenting with organophspate poisoning. Very high doses of atropine are often needed to counteract these muscarinic effects. Pralidoxime can be used alongside atropine to treat the nicotinic side effects.