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Hello friends, what will we do if our nerve signal is not passing to the motor end plate of the muscle fibres? Certainly, we would be in trouble, friends that are the same case with mYAtheNIa GraViS patients. We can see one condition here …….enjoy the NEURO RIDE$$$$

Myasthenia gravis is the neuromuscular autonomous disorder in which there is severe muscle weakness and fatigability, and it was an autoimmune disorder in which autoantibody block the acetylcholine receptors at the post synaptic neuromuscular junctions. As we go through the clinic side, we can see most of the patient often complaints of the extreme fatigue and the would be weakness of muscles of either eyes (ophthalmic myasthenia) , face ,swallowing , limps etc. there may be complaints of dysphagia, dysarthria , diplopia. In sever cases like myasthenia crisis we can see the respiratory muscle weakness may lead to death of patient unless you give them immediate ventilation. Actually the auto antibodies are self dangerous and directed towards the receptors at the motor end plate and they are produced by the plasma cells which are developed from the T-cells (thymus gland). So there is no wonder to suspect any MG for a patient who is having the thymus problems like thrymoma, infections etc. in some cases, the auto antibodies produced may be directed towards muscle specific kinase which is essential to produce the neuromuscular junctions. We can also expect the symptoms of myasthenia gravis in the patients treating with penicillamine since they are having the same antibodies. When we were baffled to put a diagnosis, we could reach a decision only after a through physical examination. We can see improvement in the fatigue for the patient who got some rest and it may worsen after some time. We can see the same after applying the ice for some time. We should do some physical examination like testing the muscle strength, we can test through making them to looking upwards and sideward for sometime( to figure out the diplopia and double vision) , looking at the feet, arm stretching, knee bending, sit ups etc. we can figure out through the repeated nerve test. And endorphonium test is helpful tool to diagnose the MG, in which we can give intravenous administration of endorphonium chloride or neostigmine and that will improve the block at the acetylcholine receptors and there would be improvement in the muscle weakness if it is a case of MG.

Rx- medicine like actylcholinestrase inhibitors like neostigmine or pyridostigmine, that will reduce the action of cholinesterase at the junction and they were given at low doses and slowly improving the dose.

Other medicine like immunosuppressive drugs –azathioprine, prednisone, cyclosporine, to improve the autoimmune dysfunction.

Plasmapheresis and intravenousimunoglobins (IVIG) are given to flush out the antibodies from the blood, as last resort.

Thymectomy is the surgical option in the case of any thymus abnormalities.

As nurse we must give the best care to them and they we should monitor the vital signs as there is good chance to get them myasthenia crisis. When we are giving the medicines

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