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10 Cards in this Set

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What is myasthenia Gravis?
Autoimmune disease characterized by weakness and easy fatiqability of skeletal muscle and is cassified according to whether the patient has only ocular or ocular and nonocular muscle weakness.
What is the pathophysicology of myasthenia gravis?
Weakness is thought to be due to an autoimmune disease or inactivation of postsynaptic acetylcholine receptors at the nmj leading to a reduced number of receptors.
what drugs are commonly used to treat muscle weakness in MG?
Anticholinesterase drugs-- they increase the amount of acetylcholine at the neuromuscular junction through inhibition of end-plate acetylcholinesterase.
What is a cholinergic crisis?
characterized by increased weakness and excessive muscarinic effects, including salivation, diarrhea, miosis and bradycardia. (caused by excessive anticholinergic)
What is the surgery of choice for MG?
Thymectomy
What is the focus of preoperative evaluation before a thymectomy?
Recent course of the disease
Muscle groups affected
Drug therapy
coexisting illnesses
what is the biggest risk with MG patients preop?
Aspiration-- pts should not receive benzodiazepines prior, and should receive Metoclopramide or an H2 Blocker to decrease this risk.
What is the response to succinylcholine by MG patients?
Unpredictable-- pts may have a resistance, a prolonged effect or and unusaul block--phase II block.
What is the response to NDMR's by MG patients?
Increased sensitivity to NDMR, even a small defasciculating dose in some may result in complete paralysis.
What are the predictive respiratory values for respiratory failure in MG patients?
disease > 6yrs
PIP of < -25cmH2O
VC <4 mL/kg
pyridostigmine dose > 750mg/d