MYASTHENIA GRAVIS SHORT NOTES

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MYASTHENIA GRAVIS SHORT NOTES

MYASTHENIA GRAVIS SHORT NOTES

  • IT IS A NEUROMUSCULAR DISEASE CHARACTERIZED BY CONSIDERABLE WEAKNESS AND ABNORMAL FATIGUE OF THE VOLUNTARY MUSCLES.

CAUSES

  • -AUTOIMMUNE DISEASE(ANTIBODY PRODUCED BY SELF BODY, DESTROYED THE ACETYLCHOLINE RECEPTOR AT NEUROMUSCULAR JUNCTION, CAUSING DECREASING THE NUMBER OF FUNCTIONAL ACETYLCHOLINE RECEPTORS.
  • -INSUFFICIENT SECRETION OF ACETYLCHOLINE
  • EXCESSIVE SECRETION OF CHOLINESTERASE(AN ENZYME WHICH DESTROYED ACETYLCHOLINE)

SIGNS AND SYMPTOMS

  • FLUCTUATING WEAKNESS OF SKELETON MUSCLES, MAINLY MUSCLES OF EYE, CHEWING, SPEAKING AND BREATHING
  • PTOSIS AND DIPLOPIA
  • DIFFICULTY IN CHEWING, SWALLOWING AND BREATHING
  • RESPIRATORY PARALYSIS AND FAILURE

DIAGNOSIS

  • TENSILON TEST (EDROPHONIUM TEST) IS USED TO DIAGNOSE MYASTHENIA GRAVIS AND CHOLINERGIC CRISIS
  • THIS TEST PLACES THE CLIENT AT RISK FOR VENTRICULAR FIBRILLATION AND CARDIAC ARREST.

ADMINISTER INJECTION EDROPHONIUM TO THE CLIENT

 1)IF MUSCLE STRENGTH IMPROVED WITHIN 30-60 SECOND, IT MEANS PATIENT HAVE MYASTHENIA GRAVIS.

2)IF CLIENT SHOWS NO IMPROVEMENT, PATIENT NEGATIVE FOR MYASTHENIA GRAVIS

3)IF MUSCLE STRENGTH DECREASE FURTHER MEANS PATIENT HAVE CHOLINERGIC CRISIS (WEAKNESS DUE TO OVERDOSE OF DRUGS).IN THIS CASE, PREPARE TO ADMINISTER INJECTION ATROPINE SULFATE, THE ANTIDOTE TO THE PATIENT.

TREATMENT

  • ADMINISTER ANTI-CHOLINESTERASE MEDICATIONS (NEOSTIGMINE, EDROPHONIUM, PHYSOSTIGMINE) THAT IMPROVE THE LEVEL OF ACETYLCHOLINE AT NEUROMUSCULAR JUNCTION.
  • MONITOR FOR RESPIRATORY FAILURE
  • ENCOURAGE THE CLIENT TO SIT UP WHILE EATING
  • ADVICE TO TAKE MEDICATION 30 MINUTES BEFORE MEAL WITH MILK TO REDUCES GIT IRRITATION
  • MAINTAIN EMERGENCY  EQUIPMENTS AT BED SIDE (FOR EMERGENCY INTUBATION INCASE OF RESPIRATORY FAILURE)
  • PERFORM PLASMAPHERESIS AND ADMINISTER IVIG (INTRAVENOUS IMMUNOGLOBULIN).

   MYASTHENIC CRISIS SIGNS AND SYMPTOMS

  • INCREASED PULSE, RESPIRATION AND BLOOD PRESSURE, DYSPNEA, BOWEL AND BLADDER INCONTINENCE, DECREASED URINE OUTPUT, ABSENT SWALLOW REFLEX, DILATED PUPIL
READ MORE  HODGKIN'S DISEASE SHORT NOTES

 CHOLINERGIC CRISIS SIGNS AND SYMPTOMS

  • DECREASED PULSE, RESPIRATION AND BLOOD PRESSURE, DIARRHOEA, MIOSIS (CONSTRICTED PUPIL)

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