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Mobile App Chapter 3: Problem 139
The diagnostic work-up of a client hospitalized with complaints of progressive weakness and fatigue confirms a diagnosis of myasthenia gravis. The medication used to treat myasthenia gravis is: A. Prostigmin (neostigmine) B. Atropine (atropine sulfate) C. Didronel (etidronate) D. Tensilon (edrophonium)
Short Answer
Expert verified
Answer: Prostigmin (neostigmine)
Step by step solution
01
Understand Myasthenia Gravis
Myasthenia gravis is an autoimmune disorder that affects the neuromuscular junctions, causing muscle weakness and fatigue. The underlying issue is the production of autoantibodies that block or destroy the nicotinic acetylcholine receptors at the neuromuscular junction, thus decreasing the efficiency of nerve impulses transmission.
02
Assess the Medication Options
To determine which medication is used to treat myasthenia gravis, let's review each one:
A. Prostigmin (neostigmine): Neostigmine is a cholinesterase inhibitor, which works by increasing the concentration of acetylcholine at the neuromuscular junction. This enhances muscle contraction and helps alleviate weakness and fatigue caused by myasthenia gravis.
B. Atropine (atropine sulfate): Atropine is an anticholinergic drug that blocks the action of acetylcholine at the muscarinic receptors. This drug is used chiefly to treat bradycardia, certain types of poisoning, and as a premedication before surgery. It is not useful in the treatment of myasthenia gravis since it would further reduce the efficiency of nerve impulses transmission.
C. Didronel (etidronate): Etidronate is a bisphosphonate drug that inhibits bone resorption by osteoclasts, thus increasing bone mineral density. It is used to treat conditions like Paget's disease and osteoporosis, but it has no direct effect on neuromuscular function and hence is not effective in treating myasthenia gravis.
D. Tensilon (edrophonium): Edrophonium is another cholinesterase inhibitor, just like neostigmine. While it is used in the diagnosis of myasthenia gravis (the Tensilon test) due to its rapid onset and short duration of action, it is not primarily used for the long-term treatment of the disorder.
03
Determine the Correct Medication
Based on the assessment of the medications, the correct answer is:
A. Prostigmin (neostigmine)
Neostigmine is a cholinesterase inhibitor that increases the concentration of acetylcholine at the neuromuscular junction, alleviating the weakness and fatigue associated with myasthenia gravis.
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Key Concepts
These are the key concepts you need to understand to accurately answer the question.
Neuromuscular Disorders
Neuromuscular disorders encompass a wide range of conditions that affect the muscles and the nerves that control them. These disorders can be the result of genetic mutations, immune system dysfunction, or environmental factors.
One particular neuromuscular disorder is myasthenia gravis, which causes muscle weakness and fatigue due to a communication breakdown at the neuromuscular junction — the critical point where nerve cells meet muscle cells. It's here that signals are transmitted from the nerves to the muscles, enabling movement, but in myasthenia gravis, these signals are impaired.
Understanding the Neuromuscular Junction:
Normally, the neurotransmitter acetylcholine binds to receptors on the muscle cells, causing them to contract. In myasthenia gravis, however, the body's immune system creates antibodies that either block or destroy these receptors, leading to weaker muscle contractions and thus muscle weakness.
One particular neuromuscular disorder is myasthenia gravis, which causes muscle weakness and fatigue due to a communication breakdown at the neuromuscular junction — the critical point where nerve cells meet muscle cells. It's here that signals are transmitted from the nerves to the muscles, enabling movement, but in myasthenia gravis, these signals are impaired.
Understanding the Neuromuscular Junction:
Normally, the neurotransmitter acetylcholine binds to receptors on the muscle cells, causing them to contract. In myasthenia gravis, however, the body's immune system creates antibodies that either block or destroy these receptors, leading to weaker muscle contractions and thus muscle weakness.
Cholinesterase Inhibitors
Cholinesterase inhibitors are a class of drugs that play a prominent role in managing neuromuscular disorders such as myasthenia gravis. These medications work by inhibiting the action of cholinesterase, an enzyme responsible for breaking down acetylcholine, the neurotransmitter used for muscle activation.
By preventing acetylcholine breakdown, cholinesterase inhibitors effectively increase its concentration in the neuromuscular junction. This, in turn, improves muscle contraction and reduces the symptoms of muscle weakness characteristic of myasthenia gravis.
Role of Cholinesterase Inhibitors:
Prostigmin (neostigmine) is one such cholinesterase inhibitor that is pivotal in the treatment of myasthenia gravis. It helps alleviate the symptoms by compensating for the reduced number of acetylcholine receptors due to the action of autoantibodies.
By preventing acetylcholine breakdown, cholinesterase inhibitors effectively increase its concentration in the neuromuscular junction. This, in turn, improves muscle contraction and reduces the symptoms of muscle weakness characteristic of myasthenia gravis.
Role of Cholinesterase Inhibitors:
Prostigmin (neostigmine) is one such cholinesterase inhibitor that is pivotal in the treatment of myasthenia gravis. It helps alleviate the symptoms by compensating for the reduced number of acetylcholine receptors due to the action of autoantibodies.
Nursing Pharmacology
Nursing pharmacology involves the study of how drugs interact with the human body to treat and manage illnesses. It's an essential aspect of nursing care, as it requires nurses to understand the mechanisms of action, therapeutic uses, potential side effects, and interactions of medications.
In the context of myasthenia gravis, nurses must be well-versed in administering treatments like cholinesterase inhibitors and monitoring their effects on patients. Effective management includes titrating dosages to balance symptom relief with possible side effects such as muscle cramps or diarrhea.
Ensuring Optimum Care:
Nurses play a crucial role in educating patients about their condition and treatment regimen, ensuring that they understand why adherence to medication is critical in managing symptoms of neuromuscular disorders.
In the context of myasthenia gravis, nurses must be well-versed in administering treatments like cholinesterase inhibitors and monitoring their effects on patients. Effective management includes titrating dosages to balance symptom relief with possible side effects such as muscle cramps or diarrhea.
Ensuring Optimum Care:
Nurses play a crucial role in educating patients about their condition and treatment regimen, ensuring that they understand why adherence to medication is critical in managing symptoms of neuromuscular disorders.
Autoimmune Disorders
Autoimmune disorders arise when the body's immune system mistakenly attacks its own cells and tissues. There are many types of autoimmune diseases, each with unique characteristics and treatment approaches.
Myasthenia gravis is an autoimmune disorder targeting the neuromuscular junction. The body produces autoantibodies against acetylcholine receptors, disrupting normal muscular function and causing the characteristic symptoms of the disease.
The Body’s Misguided Response:
Understanding that this condition is an autoimmune process emphasizes the importance of treatments that manage the immune system's response. While drugs like cholinesterase inhibitors treat symptoms, other treatments may include immunosuppressants or therapies to reduce antibody production, thereby addressing the root cause of the symptoms.
Myasthenia gravis is an autoimmune disorder targeting the neuromuscular junction. The body produces autoantibodies against acetylcholine receptors, disrupting normal muscular function and causing the characteristic symptoms of the disease.
The Body’s Misguided Response:
Understanding that this condition is an autoimmune process emphasizes the importance of treatments that manage the immune system's response. While drugs like cholinesterase inhibitors treat symptoms, other treatments may include immunosuppressants or therapies to reduce antibody production, thereby addressing the root cause of the symptoms.
