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Publisher Summary This chapter discusses the principles of the current treatment of myasthenia gravis (MG). Modern therapy for severe MG, based on increasing knowledge of the autoimmune background and pathogenetic mechanisms, and advances in intensive care, has improved the management of these patients, with a dramatic decrease in mortality. Muscular weakness and fatigue in MG typically vary considerably in severity and location among different patients, and in the same patient during different periods of time. Because of the varying natural course of MG, it is difficult to evaluate the effect of individual treatments in uncontrolled studies, especially when multiple therapeutic approaches are used simultaneously. The diagnosis of MG is based on clinical criteria, neurophysiological studies and the presence of acetylcholine receptor antibodies in the serum. The clinical pharmacology of the two most commonly used drugs, neostigmine and pyridostigmine, are thoroughly studied. The clinical responsiveness to anticholinesterases slowly decreases in the first months of treatment, necessitating higher dosages to obtain the same effect. Ephedrine, aminophylline, and potassium salts are used as adjuvant therapies. |
