There is a narrow margin between first appearance of adverse reaction to AChE inhibitors and serious toxic effects. Adverse reactions that require immediate action include:

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Fasciculations of voluntary muscles indicate overstimulation of the neuromuscular junction and can quickly progress to respiratory failure. Immediate action is necessary to prevent further toxicity. Dizziness, headache, and nausea are common but less urgent adverse reactions. Decreased salivation is actually a therapeutic effect of AChE inhibitors for conditions such as dry mouth.

There Is a Narrow Margin Between First Appearance of Adverse