[TOC]
- Antibodies to acetylcholine receptors
- Decremental response to repetitive stimulation
- Clinical response to cholinergic agents
- Myasthenia Crisis
- Weak respiratory muscles and bulbar muscles
- Precipitated by infection or medications
- Monitor: vital capacity, maximum inspiratory pressure | intubate accordingly
- Treat precipitating causes
- Treatment:
- Plasma exchange
- IVIG
- Immunomodulating therapy + high dose steroids
- Medications that worsen myasthenia gravis
- Neuromuscular junction blocking agents
- Antibiotics -- aminoglycosides, fluoroquinolones, macrolides
- Cardiovascular drugs -- β-blockers, procainamide, quinidine
- Miscellaneous -- chloroquine, hydroxychloroquine, quinidine, magnesium, botulinum toxin, penicillamine, anti-PD-1 monoclonal antibodies