Pharm Exam 4 – Review Questions & Answers |
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Terms in this set (68)
Myasthenia Gravis •Autoimmune disorder
-Pathophysiology •Antibodies attach to acetylcholine receptor sites,
-Lack of? obstruct binding of acetylcholine, and destroy
-Causes? receptor sites
•Lack of acetylcholine in the neuromuscular junction
leads to ineffective muscle contraction and muscle
weakness
Signs and Symptoms:
Skeletal muscle weakness
fatigue
ptosis
dysphagia
dysarthria
respiratory muscle weakness
paralysis
respiratory arrest
,Myasthenic crisis in MG Not enough acetylcholine available.
Think Dry and weak not enough medications likely
The body doesn't have enough acetylcholine
stimulation.
Muscles cannot contract well.
So the symptoms are just extreme MG weakness.
Symptoms:
Severe muscle weakness
Drooping eyelids
Difficulty swallowing
Weak breathing muscles
Possible respiratory failure
Important thing:
No excess body fluids
The patient just looks weak and tired.
Not enough acetylcholine → muscles cannot
activate
Treatments
Give more MG medication.
,Cholinergic crisis in MG too much acetylcholine.
think Wet and weak too much medication possibly
There is too much acetylcholine.
**Acetylcholine also controls the parasympathetic
nervous system.
-Parasympathetic = rest and digest
So if there is too much acetylcholine, you get
parasympathetic overload.
This causes excess secretions everywhere.
Symptoms:
Drooling
Sweating
Diarrhea
Vomiting
Bronchial secretions
Small pupils
Slow heart rate
Plus muscle weakness.
Too much acetylcholine → receptors get
overstimulated and stop responding
Muscles eventually stop working
Treatment: Give Atropine
Atropine blocks acetylcholine effects.
, Edrophonium Chloride (Tensilon) **used to diagnose Myasthenia Gravis** (The Tensilon
EDROPHONIUM → "EYE-DROP- Test)
onium" -Edrophonium is an acetylcholinesterase inhibitor.
That means it prevents acetylcholine from being
broken down.
Result: More acetylcholine is available
Which means: Stronger muscle contraction
But the key thing about this drug is:
It works VERY fast
It lasts only 5–20 minutes
Why this drug is used to diagnose Myasthenia Gravis
-If we suddenly give a drug that increases
acetylcholine, the muscles should temporarily get
stronger.
-That improvement tells us the patient likely has
Myasthenia Gravis.
Pyridostigmine Bromide (Mestinon) This is the main drug used to treat myasthenia
-Side Effects: gravis long-term.
-Drug Class: Cholinesterase Inhibitors (AChE
Inhibitors)
**In myasthenia gravis the immune system destroys
acetylcholine receptors on muscles. -----> this drug
Increasing acetylcholine -----> That gives the few
remaining receptors more chances to get stimulated.
-Pyridostigmine does not last very long.
-So patients take it: Every 3–6 hours
-This is important because: Missing doses can cause
myasthenic crisis.
***After determining that the client has a Myasthenic
Crisis, Neostigmine or Pyridostigmine will be
administered IV until the patient can safely take PO
Accurate Solutions
Save
Terms in this set (68)
Myasthenia Gravis •Autoimmune disorder
-Pathophysiology •Antibodies attach to acetylcholine receptor sites,
-Lack of? obstruct binding of acetylcholine, and destroy
-Causes? receptor sites
•Lack of acetylcholine in the neuromuscular junction
leads to ineffective muscle contraction and muscle
weakness
Signs and Symptoms:
Skeletal muscle weakness
fatigue
ptosis
dysphagia
dysarthria
respiratory muscle weakness
paralysis
respiratory arrest
,Myasthenic crisis in MG Not enough acetylcholine available.
Think Dry and weak not enough medications likely
The body doesn't have enough acetylcholine
stimulation.
Muscles cannot contract well.
So the symptoms are just extreme MG weakness.
Symptoms:
Severe muscle weakness
Drooping eyelids
Difficulty swallowing
Weak breathing muscles
Possible respiratory failure
Important thing:
No excess body fluids
The patient just looks weak and tired.
Not enough acetylcholine → muscles cannot
activate
Treatments
Give more MG medication.
,Cholinergic crisis in MG too much acetylcholine.
think Wet and weak too much medication possibly
There is too much acetylcholine.
**Acetylcholine also controls the parasympathetic
nervous system.
-Parasympathetic = rest and digest
So if there is too much acetylcholine, you get
parasympathetic overload.
This causes excess secretions everywhere.
Symptoms:
Drooling
Sweating
Diarrhea
Vomiting
Bronchial secretions
Small pupils
Slow heart rate
Plus muscle weakness.
Too much acetylcholine → receptors get
overstimulated and stop responding
Muscles eventually stop working
Treatment: Give Atropine
Atropine blocks acetylcholine effects.
, Edrophonium Chloride (Tensilon) **used to diagnose Myasthenia Gravis** (The Tensilon
EDROPHONIUM → "EYE-DROP- Test)
onium" -Edrophonium is an acetylcholinesterase inhibitor.
That means it prevents acetylcholine from being
broken down.
Result: More acetylcholine is available
Which means: Stronger muscle contraction
But the key thing about this drug is:
It works VERY fast
It lasts only 5–20 minutes
Why this drug is used to diagnose Myasthenia Gravis
-If we suddenly give a drug that increases
acetylcholine, the muscles should temporarily get
stronger.
-That improvement tells us the patient likely has
Myasthenia Gravis.
Pyridostigmine Bromide (Mestinon) This is the main drug used to treat myasthenia
-Side Effects: gravis long-term.
-Drug Class: Cholinesterase Inhibitors (AChE
Inhibitors)
**In myasthenia gravis the immune system destroys
acetylcholine receptors on muscles. -----> this drug
Increasing acetylcholine -----> That gives the few
remaining receptors more chances to get stimulated.
-Pyridostigmine does not last very long.
-So patients take it: Every 3–6 hours
-This is important because: Missing doses can cause
myasthenic crisis.
***After determining that the client has a Myasthenic
Crisis, Neostigmine or Pyridostigmine will be
administered IV until the patient can safely take PO
