Myasthenia Gravis

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Myasthenia Gravis
2009-11-21 20:13:25
Myasthenia Gravis

Myasthenia Gravis
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  1. Myasthenia Gravis
    • fatigue and muscle weakness
    • autoimmune disease-body attacks ACh receptors
    • comes & goes
  2. Myasthenia Gravis-assessment
    • muscle weakness
    • poor posture
    • ocular palsies
    • ptosis
    • weak or incomplete eye closure
    • diplopia
    • resp compromise
    • loss of B/B control
    • fatigue
    • myalgias
    • paresthesias
    • decreased smell and tast
  3. Myasthenia Gravis-diagnosis
    • confirmed by electromyography (EMG)
    • rule out thyroid disease-symptoms are similar
    • tensilon testing: cholinesterase inhibitors injected, myasthenic patients will show marked improvement 4-5 minutes
    • (danger of ventricular fib or cardiac arrest. Have atropine available)
  4. Myasthenia Gravis-non surgical management
    • respiratory support
    • promote mobility
    • drug therapy: cholinesterase inhibitors
  5. Myasthenic Crisis vs.
    Cholinergic Crisis
    • Myasthenic Crisis
    • flare-up or worsening of symptoms caused by not enough anticholinesterase drugs

    • Cholinergic Crisis
    • muscle weakness caused by too many anticholinesterase drugs
  6. Emergency Care:
    Myasthenic Crisis
    Cholinergic Crisis
    • Myasthenic Crisis:
    • Priority is managing airway. May need mechanical ventilation.

    • Cholinergic Crisis:
    • Do Not Give Anticholinergic Drugs While Patient is on Mechanical Ventilation.
  7. Myasthenia Gravis-surgical management
  8. Myasthenia Gravis-health teaching
    • avoid heat: spas, hot tubs, sunbathing
    • avoid crowds
    • avoid overeating
    • keep manual resuscitation bag and suctioning equip in home