Myasthenia Gravis (MG)

Question 1

What is Myasthenia Gravis (MG) and what does it affect?

Answer 1

Autoimmune disorder where antibodies generated against N-Ach-R’s at skeletal motor endplate

Affects skeletal muscle

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Question 2

What are the s/s of MG?

Answer 2

• Muscle weakness
• Diplopia
• Ptosis
• laryngeal/pharyngeal weakess
• Thymic hyperplasia

Question 3

What exacerbates the s/s of MG?

Answer 3

• excercise
• pain
• insomnia
• infection
• surgery

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Question 4

What are the treatments for MG?

Answer 4

• Ach-E inhibitors (Pyridostigmine)
• immunosuppressive agents
• steroids
• plasmapheresis
• IVIG
• Thymectomy

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Question 5

Preanesthetic Considerations for MG

Assess existing ____

Optimize ____ function

Consider pre-op____ in anyone with long-term steroid use

Counsel patients on the increased risk of needing post-op resp ____ until fully recovered from anesthesia

Answer 5

Assess existing deficits

Optimize respiratory function

Consider pre-op steroids in anyone with long-term steroid use

Counsel patients on the increased risk of needing post-op resp support/ventilation until fully recovered from anesthesia

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Question 6

What medications of be cautious with MG patients?

Answer 6

1. Paralytics - avoid prolonged muscle weakness
2. Opiods - avoid respiratory compromise
3. ACh-E inhibitors - may proling Succs and Ester LAs

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Question 7

What labs and tests to consider with MG?

Answer 7

• CBC
• BMP
• +/-LFT (if on Dantrolene & Azathioprine)
• GLUCOSE & ELECTROLYTES check (due to Steroids)
• Pulmonary Function Tests (if respiratory compromise)

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