Neurologic Disorders Flashcards
It is an autoimmune neuromuscular disorder that affects the myoneural junction that results to the weakness of voluntary muscles.
MYASTHENIA GRAVIS
A person with myasthenia gravis is characterized by:
Excessive weakness of voluntary muscles (striated muscles).
The principal factors interfering with neuromuscular transmission
ACETYLCHOLINE RECEPTOR ANTIBODIES
Peak onset of Myasthenia Gravis in Women and Men
Women = 20-30 y/o
Men = 60-70 y/o
Clinical Manifestations of Myasthenia Gravis
- Ptosis diplopia, strabismus
- Snarl smile, mask-like expression
- Drooling
- Dyspnea, dysphagia
Diagnostic tests for Myasthenia Gravis
- Neurologic exam
- Tensilon test
- Ice test
- Nerve Conduction studies
- Single Fiber Electromyography
- CT scan and MRI
Medication given during Tensilon Test
Edrophonium IV 2mg then 8 mg
Antidote for Edrophonium used during Tensilon test
Atropine Sulfate
Side effects of Tensilon Test
- Bradycardia
- Asystole
- Bronchoconstriction
- Diaphoresis
- Cramping
Explain how Tensilon test is done for Myasthenia Gravis
Pt will be given edrophonium IV 2mg then 8mg. If pt improves after 30 seconds of injection then he/she (+) for MG
How is Ice Test done for pt with suspected MG
Ice pack wrapped in towel will be applied to eyes for 2-5 minutes. If pt will no longer have ptosis, then he/she (+) for MG
Give cytotoxic medication for tx of myasthenia gravis
AZATHIOPRINE
Pharmacotherapy for Myasthenia Gravis and its medications
- Acetylcholinesterase inhibitors
- Prostigmin (Neostigmin)
- Mestinon (Pyridostigmine)
- Mytelase (Ambenomium) - Immunomodulating drugs
- Prednisone - Cytotoxic medications
- Azathioprine - IVIG
- Human-gamma globulin - Glucocorticoids
- Antacids
Give acetylcholinesterase inhibitors for tx of myasthenia gravis
Acetylcholinesterase inhibitors:
1. Prostigmin (Neostigmin)
2. Mestinon (Pyridostigmine)
3. Mytelase (Ambenomium)
Drug that is contraindicated for pt’s with Myasthenia Gravis
PROCAINE
Surgical management for Myasthenia Gravis
THYMECTOMY - removal of thymus gland
Give immunomodulating for tx of myasthenia gravis
PREDNISONE
Nursing Interventions for pt with Myasthenia gravis
- Assess swallowing & gag reflex before feeding
- Administer meds 20-30 mins before meals
- Protect pt from falls
- Start meal with cold beverages
- Promote adequate ventilation
Complications of Myasthenia Gravis
- Myasthenic Crisis - under medication
- Cholinergic Crisis - excessive medication
Signs of Myasthenic Crisis
- Sudden increase in BP
- Severe respi distress & cyanosis
- Increased secretions
- Diaphoresis
- Dysarthria
- Increased lacrimation
A progressive neurodegenerative due to disequilibrium between dopamine and acetylcholine.
Most common effect of prolonged use of antipsychotic drug
PARKINSON’S DISEASE
Signs & symptoms of Parkinson’s disease
- Bradykinesia
- Pill-rolling tremors
- Mask-like blank expression
- Stooped posture
- Rigidity of muscles
Pharmacotherapy for Parkinson’s disease
- Anticholinergics
- Artane (Trihexyphenidyl)
- Cogentin (Benztropine)
- Akineton (Biperiden) - Dopaminergics
- Levodopa
- Levodopa-Carbidopa (Simenet) - Dopamine Agonist / Antiviral Dugs
- Symmetrel (Amantadine HCl)
- Parlodel (Bromocriptine Mesylate)
Surgical management for Parkinson’s disease where a destructive lesion is placed in the basal ganglia.
Indicated for pts whose rigidity, tremor, bradykinesia are uncontrollable by medical management
PALLIDOTOMY
