341 - Myasthenia Gravis Treatment

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  1. Pyridostigmine
    • Oral Acetylcholinesterase Inhibitor
    • It increases the amount of ACh in the synaptic cleft
    • Side effects: Significant gastrointestinal symptoms
  2. Corticosteroid Therapy
    • Corticosteroids suppress the immune system
    • Indicated for myasthenia gravis patients with mild symptoms who don't respond to conventional treatments
    • Prednisone: Increase dose slowly (to avoid myasthenic crisis) until symptoms are gone, always taper off a corticosteroid
    • Side effects: Weight gain, cataracts, diabetes, insomnia, mood change, osteoporosis
  3. Immunosuppressive drugs
    • Used in severe myasthenia gravis patients
    • Results in a profound decrease in immune response
    • Azathoprine, cyclosporine, cyclophosphamide
  4. Plasma Exchange (Plasmapheresis)
    Removes circulating antibodies (temporary improvement)
  5. Intravenous Immunoglobulin Infusion
    • Unknown mechansim
    • Temporarily relieves condition
  6. Thymectomy
    • Removal of the thymus gland (not a good idea in patients <20 years old)
    • Option for moderate to severe seropositive myasthenia gravis patietns who aren't controlled by drug therapy
    • Only for patients <45 years old (past that age removing the thymus has little effect)
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341 - Myasthenia Gravis Treatment

PHAR 341 Myasthenia Gravis Treatment
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