Family Nurse Practitioner Exam

Which condition is characterized by dilated pupils, confusion, and flushing?

1. Anticholinergic overdose

2. Opioid overdose

3. Serotonin syndrome

4. Hypoglycemia

The correct answer is: Anticholinergic overdose

The condition characterized by dilated pupils, confusion, and flushing is indeed anticholinergic overdose. In this scenario, the anticholinergic agents inhibit the neurotransmitter acetylcholine in the central and peripheral nervous systems, leading to a variety of symptoms. Dilated pupils, known as mydriasis, occur due to the effect of these agents on the muscles controlling pupil size. Additionally, confusion results from impaired synaptic transmission and reduction in the parasympathetic nervous system's activity, affecting cognitive functions. Flushing, or vasodilation of the skin, can result from the anticholinergic effects on the autonomic nervous system. This set of symptoms distinctly reflects the physiological changes brought on by excessive anticholinergic activity, differentiating it from the symptoms expected in other conditions such as opioid overdose, which typically causes pinpoint pupils and respiratory depression, serotonin syndrome, which would present with a range of symptoms including hyperreflexia and increased heart rate, or hypoglycemia, which generally causes symptoms related to low blood sugar, such as sweating, shaking, and tachycardia.