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- fatigue and muscle weakness
- autoimmune disease-body attacks ACh receptors
- comes & goes
- muscle weakness
- poor posture
- ocular palsies
- weak or incomplete eye closure
- resp compromise
- loss of B/B control
- decreased smell and tast
- 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)
Myasthenia Gravis-non surgical management
- respiratory support
- promote mobility
- drug therapy: cholinesterase inhibitors
Myasthenic Crisis vs.
- Myasthenic Crisis
- flare-up or worsening of symptoms caused by not enough anticholinesterase drugs
- Cholinergic Crisis
- muscle weakness caused by too many anticholinesterase drugs
- Myasthenic Crisis:
- Priority is managing airway. May need mechanical ventilation.
- Cholinergic Crisis:
- Do Not Give Anticholinergic Drugs While Patient is on Mechanical Ventilation.
Myasthenia Gravis-surgical management
Myasthenia Gravis-health teaching
- avoid heat: spas, hot tubs, sunbathing
- avoid crowds
- avoid overeating
- keep manual resuscitation bag and suctioning equip in home
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