Myasthenia gravis treatment steroids

Acetylcholinesterase inhibitors can provide symptomatic benefit and may not fully remove a person's weakness from MG. [45] While they might not fully remove all symptoms of MG, they still may allow a person the ability to perform normal daily activities. [45] Usually, acetylcholinesterase inhibitors are started at a low dose and increased until the desired result is achieved. If taken 30 minutes before a meal, symptoms will be mild during eating, which is helpful for those who have difficulty swallowing due to their illness. Another medication used for MG, atropine , can reduce the muscarinic side effects of acetylcholinesterase inhibitors. [46] Pyridostigmine is a relatively long-acting drug (when compared to other cholinergic agonists), with a half-life around four hours with relatively few side effects. [47] Generally, it is discontinued in those who are being mechanically ventilated as it is known to increase the amount of salivary secretions. [47] A few high-quality studies have directly compared cholinesterase inhibitors with other treatments (or placebo); their practical benefit may be such that it would be difficult to conduct studies in which they would be withheld from some people. [48] The steroid prednisone might also be used to achieve a better result, but it can lead to the worsening of symptoms for 14 days and takes 6–8 weeks to achieve its maximal effectiveness. [47] Due to the myriad symptoms that steroid treatments can cause, it is not the preferred method of treatment. [47] Other immune suppressing medications may also be used including rituximab . [49]

Caution should be used when high-dose prednisone is given to patients as up to 50% of patients may develop a transient deterioration with possible precipitation of MG crisis. The transient worsening usually occurs 5 to 10 days after dose initiation and lasts for about a week. For this reason, high-dose prednisone should be started in hospitalized patients receiving concurrent rapid induction immunotherapy. Alternatively, a slow dose escalation regimen should be used to reach a target dose of 1mg/kg (usually 50-80 mg/day) over 3 to 4 weeks. In patients with mild to moderate MG symptoms, a lower dose of 20 to 40 mg per day is sufficient.

Myasthenia gravis treatment steroids

myasthenia gravis treatment steroids


myasthenia gravis treatment steroidsmyasthenia gravis treatment steroidsmyasthenia gravis treatment steroidsmyasthenia gravis treatment steroidsmyasthenia gravis treatment steroids