Which finding indicates anticholinergic toxicity?

• A. Hot, dry skin with dilated pupils.
• B. Excessive sweating and salivation.
• C. Constricted pupils.
• D. Drooling.

Answer: (A)

Anticholinergic toxicity occurs when muscarinic receptors are blocked, shutting down parasympathetic effects. This produces 'hot, dry, and dilated' features: sweating is inhibited, so the skin becomes dry and can feel hot, and the pupils dilate (mydriasis) because the eye isn’t receiving parasympathetic constriction. That combination—hot, dry skin with dilated pupils—is the classic sign of anticholinergic toxicity.

Excessive sweating and salivation point to cholinergic overstimulation, not blockade. Constricted pupils would reflect increased parasympathetic activity, again opposite to anticholinergic effects. Drooling likewise indicates secretions driven by parasympathetic stimulation, not blockade.