Myasthenia Gravis

• Myasthenia gravis is an autoimmune disease that blocks acetylcholine which tells the body how to move resulting in weak skeletal muscle
• Clinical Signs

  • diplopia, mask-like affect, ptosis, dysphagia, choking, and eventually respiratory compromise
  • muscle weakness that worsens with activity and improves with rest
• Diagnostic Studies

  • Tensilon (edrophonium chloride) test: if they improve, they have the disease
• Cholinergic Crisis is when there is too much anticholinesterase drug in the system. person gets weak muscles all over
• Myasthenic Crisis is when there is little medication in the system. person gets weak muscles all over
• Drug Therapy

  • anticholinesterase agents: pyridostigmine
  • corticosteroids
  • Immunosuppressive agents: azathioprine, mycophenolate
• Nursing Interventions

  • Ensure tracheostomy kit for myasthenic crisis
  • Allow for rest periods
  • Encourage deep breathing and coughing every 4-6 hours