The acronym SLUDGEM is used to describe the signs and symptoms of exposure to which category of warfare agents?

• A. Blister agents
• B. Blood agents
• C. Nerve agents
• D. Choking agents

Answer: (C)

SLUDGEM is the signature set of muscarinic cholinergic signs from nerve-agent exposure. It stands for Salivation, Lacrimation, Urination, Defecation, Gastric upset, Emesis, and Miosis. These symptoms come from acetylcholinesterase inhibition caused by nerve agents, leading to excess acetylcholine and overstimulation of muscarinic receptors. That cholinergic crisis specifically produces increased secretions and GI/urinary symptoms with pinpoint pupils, which is why this cluster points to nerve agents rather than blister agents (which irritate skin and lungs), blood agents (which impair cellular respiration), or choking agents (which cause coughing and pulmonary edema).