Myasthenia gravis treatment

Lower respiratory tract infections treatment of Macrolide antibiotics Manic symptoms drug-induced Migraine headaches treatment of Monoamine oxidase inhibitors contemporary treatment of depression Multiple sclerosis treatment of Myasthenia gravis treatment of Mycoses treatment of deep-seated organisms Myoclonus treatment of Narcolepsy treatment of Neurotransmitters and their receptor subtypes Newborns undeveloped pharmacokinetic profile Nitrate products... 

The anainoacridines, tacrine (19) and its 1-hydroxy metaboUte, velnacrine (20), are reversible inhibitors of AChE. Tacrine was synthesi2ed in the 1940s and has been used clinically for the treatment of myasthenia gravis and tardive dyskinesia (115). Placebo-controUed studies have indicated modest efficacy of tacrine to treat AD dementia (122,123) and in 1993 the dmg was recommended for approval by the PDA under the trade name Cognex. Tacrine (19) has been shown to interact with sites other than AChE, such as potassium channels (124) and muscarinic receptors. However, these interactions are comparatively weak and are not thought to contribute to the biological activity of the dmg at therapeutic levels (115). 

ChEI treatments have been expanded also to include other dementias and CNS disorders, e.g. delirium, traumatic brain injuries and memory impairments, as well as myasthenia gravis, glaucoma and parasite infections. 

The major uses of the cholinergic drugp are in the treatment of glaucoma, myasthenia gravis, and urinary retention. 

D.F.P. was administered intramuscularly in small doses to ten patients for periods varying from 2 weeks to 2 years. It was concluded that D.F.P. was not a very suitable drug for the routine treatment of myasthenia gravis, since it did not relieve signs and symptoms as effectively and consistently as neostigmine. 

Clinical use of reversible inhibitors is directed to eye, skeletal muscle, neuromuscular junctions, gastrointestinal tract, urinary tract, respiratory tract, and heart and used in treatment of glaucoma (an ocular disease caused by increased intraocular pressure due to inadequate drainage of aqueous humor at filtration angle), myasthenia gravis (an autoimmune disease... 

Because anticholinesterase agents also inhibit plasma pseudo-ChE, they will potentiate the effects of succinylcholine by inhibiting its breakdown. This is important, for example, when succinylcholine is to be employed in patients who have previously received cholinesterase inhibitors for the treatment of myasthenia gravis or glaucoma. 

Increasing muscle weakness of myasthenia gravis may occur. Antidote 0.5-1 mg IV atropine sulfate with other supportive treatment. 

Unlabeled Uses Treatment of biliary cirrhosis, chronic acfive hepatitis, glomerulonephritis, inflammatory bowel disease, inflammatory myopathy, multiple sclerosis, myasthenia gravis, nephrotic syndrome, pemphigoid, pemphigus, polymyositis, systemic lupus erythematosus... 

Grob, D., Johns, R.J. 1958. Treatment of anticholinesterase Intoxication with oximes. Use in normal subjects and in patients with myasthenia gravis. J. Am. Med. Assn. 166 1855-1858. 

In the treatment of tetanus and emergency of epilepsy (status epilepticus). As a diagnostic tool for myasthenia gravis. 

Neostigmine is a drug of choice in the treatment of myasthenia gravis, a chronic disease characterized by muscular weakness and rapid fatiguability of the skeletal muscles due to impaired neuromuscular transmission. The defect may be presynaptic or postsynaptic. 

Apart from neostigmine, pyridostigmine and ambenonium are the other standard drugs used in the treatment of myasthenia gravis. 

The major therapeutic uses of the cholinomimetics are for diseases of the eye (glaucoma, accommodative esotropia), the gastrointestinal and urinary tracts (postoperative atony, neurogenic bladder), the neuromuscular junction (myasthenia gravis, curare-induced neuromuscular paralysis), and very rarely, the heart (certain atrial arrhythmias). Cholinesterase inhibitors are occasionally used in the treatment of atropine overdosage. Several newer cholinesterase inhibitors are being used to treat patients with Alzheimer s disease. 

Edrophonium is also used to assess the adequacy of treatment with the longer-acting cholinesterase inhibitors in patients with myasthenia gravis. If excessive amounts of cholinesterase inhibitor have been used, patients may become paradoxically weak because of nicotinic depolarizing blockade of the motor end plate. 

Edrophonium Alcohol, binds briefly to active site of acetylcholinesterase (AChE) and prevents access of acetylcholine (ACh) Amplifies all actions of ACh increases parasympathetic activity and somatic neuromuscular transmission Diagnosis and acute treatment of myasthenia gravis Parenteral quaternary amine does not enter CNS Toxicity Parasympathomimetic excess Interactions Additive with parasympathomimetics... 

Uses treatment of myasthenia gravis (has fewer side effects -salivation, Gl disturbances, bradycardia- than neostigmine) antidote to nondepolarizing blockade caused by muscle relaxants during surgery. 

One of the best-understood autoimmune diseases is myasthenia gravis, a condition associated with a decrease in the number of functional post-synaptic nicotinic acetylcholine receptors (Fig. 30-23) in neuromuscular junctions. e The resulting extreme muscular weakness can be fatal. Myasthenia gravis is not rare and affects about one in 10,000 peopled An interesting treatment consists of the administration of physostigmine, diisopropyl-phosphofluoridate (Chapter 12, Section C,l), or other acetylcholinesterase inhibitors (Box 12-E). These very toxic compounds, when administered in controlled amounts, permit accumulation of higher acetylcholine concentration with a resultant activation of muscular contraction. The same compounds... 

Delrieu F, Menkes Cl, Sainte-Croix A, Babinet P, Chesneau AM, Delbarre F. Myasthenie et thyroidite auto-immune au course du traitements de la polyarthrite rhumato ide par la D-penicillamine. Etude anatomo-clini-que d un cas. [Myasthenia gravis and autoimmune thyroiditis during the treatment of rheumatoid polyarthritis with D-penicillamine. Anatomoclinical study of 1 case.] Ann Med Interne (Paris) 1976 127(10) 739-43. 

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