MYSTENIA GRAVIS Acetylcholinesterase Inhibitors. UNIT 5

Question 1

Which of the following drugs are Acetylcholinesterase Inhibitors. Select all that apply

A.Rivastigmine
B. Cyclobenzaprine
C. Pyridostigmine
D. Digoxin
E. Albuterol

Answer 1

C. Pyridostigmine
A.Rivastigmine

Question 2

What is Myasthenia Gravis

Answer 2

Autoimmune disorder
 Antibodies attach to acetylcholine receptor sites,
obstruct binding of acetylcholine, and destroy receptor
sites
 Lack of acetylcholine impairs transmission of messages
at neuromuscular junctions
* Leads to ineffective muscle contraction and muscle weakness
* Leads to weakness of respiratory, facial, and extremity muscle

Question 3

Action of Pyridostigmine

Answer 3

Pyridostigmine
 Action – Improves transmission of messages down the
nerves by inhibiting the destruction of Ach. Allows Ach to
move down the nerves peripherally
 Think P-pyridostigmine and P-peripheral
 Use – Control the symptoms of (MG)
 Increase muscle strength

Question 4

Side effects and Adverse effects of Pyridostigmine

Answer 4

Pyridostigmine
 Side effects/adverse reactions
 GI disturbances (nausea, vomiting, diarrhea, abdominal
cramps
 Increased salivation, sweating, tearing
 Miosis, blurred vision

Abdominal pain, confusion, depression, diarrhea, blurred vision, hyperesthesia, fecal and urinary incontinence, seizures

Adverse Effect
 Bradycardia
 Hypotension

Bradycardia, cardiac dysrhythmias, COPD, hypertension, and seizures

Question 5

Pyridostigmine  Contraindications  Interactions  Caution

Answer 5

Pyridostigmine
 Contraindications
 GI/GU obstruction

 Caution
 Bradycardia, arrhythmias, hypotension
 Peptic ulcer
 Asthma

 Interactions
 Atropine (other anti-cholinergic drugs), other drugs that decrease
HR or BP
 Best given before meals empty stomach

Question 6

Nursing Intervention for Pyridostigmine

Answer 6

Acetylcholinesterase Inhibitors -
Pyridostigmine
 Nursing interventions
 Monitor VS, including respiratory system
 Monitor for side effects/adverse reactions
 Monitor for decreased muscle strength
 Administer doses on time before meals
 Monitor drug effectiveness

Question 7

Patient Teaching for Pyridostigmine

Answer 7

Patient teaching
 Encourage patient to wear medical identification
 Take drug as ordered on empty stomach before meals.
Do not skip doses
 To side effects/adverse reactions to report
 To notify health care provider of addition of medications

Question 8

acetylcholinesterase Inhibitors -
Pyridostigmine EVALUATION

Answer 8

cetylcholinesterase Inhibitors -
Pyridostigmine
 Evaluation
 Improved muscle strength
 Absence of respiratory distress
 Compliance with medication

Question 9

1. When the nurse explains the pathophysiology of myasthenia gravis to a patient, which is the best explanation?
   a. Degeneration of cholinergic neurons and a deficit in acetylcholine lead to neuritic plaques and neurofibrillary tangles.
   b. A decreased amount of acetylcholine to cholinergic receptors produces weak muscles and reduced nerve impulses.
   c. Myelin sheaths of nerve fibers in the brain and spinal cord develop lesions or plaques affecting the nervous system.
   d. An imbalance of dopamine and acetylcholine leads to degeneration of neurons in midbrain and extrapyramidal motor tracts.

Answer 9

b. A decreased amount of acetylcholine to cholinergic receptors produces weak muscles and reduced nerve impulses.