The cholinergic syndrome is the result of increased acetylcholine activity at central and peripheral muscarinic and nicotinic receptors and is potentially lethal. Acetylcholine is the neurotransmitter at pre- and post-ganglionic parasympathetic, pre-ganglionic sympathetic and somatic nerves. It is also an important neurotransmitter in the CNS. Cholinergic syndrome arises from either acetylcholinesterase enzyme inhibition or direct agonist action at muscarinic or nicotinic receptors.
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