Acute intoxication manifests within 10–60 minutes with severe gastrointestinal symptoms, such as vomiting, epigastric discomfort, and profuse watery diarrhea. This is soon followed by skeletal muscle weakness due to profound hypokalemia, that progresses to flaccid paralysis, areflexia, and respiratory failure. Ventricular arrhythmias, hypophosphatemia, mydriasis, impaired visual accommodation, myoclonus, salivation, hypertension, convulsions, rhabdomyolysis, acute renal failure, and coagulopathy may also occur. Profound lactic acidosis and CNS depression may be present. More often, patients remain conscious even when severely poisoned.