From the Guidelines
Patients with myasthenia symptoms should avoid medications that can worsen their condition, such as β-blockers, IV magnesium, fluoroquinolones, aminoglycosides, and macrolides, and instead be treated with a 5-day course of plasmapheresis or a 2 g/kg course of IVIG over 5 days, along with 1–2 mg/kg methylprednisolone daily and pyridostigmine, with weaning based on symptom improvement 1. When managing myasthenia symptoms, it is crucial to consider the potential impact of various medications on the condition. Certain medications, including β-blockers, IV magnesium, fluoroquinolones, aminoglycosides, and macrolides, can exacerbate myasthenia symptoms and should be avoided 1. Key considerations for treatment include:
- A 5-day course of plasmapheresis or a 2 g/kg course of IVIG over 5 days to help manage symptoms
- Administration of 1–2 mg/kg methylprednisolone daily, with weaning based on symptom improvement
- Use of pyridostigmine, with weaning based on improvement
- Potential for ICPi-associated myasthenia gravis to be monophasic, which may not require additional corticosteroid-sparing agents 1. It is essential to prioritize these treatment approaches to effectively manage myasthenia symptoms and improve patient outcomes, focusing on minimizing morbidity, mortality, and enhancing quality of life.
From the Research
Myasthenia Symptoms
- Myasthenia gravis is a chronic autoimmune disorder characterized by weakness and fatigue in skeletal muscles, which can be exacerbated by physical activity and improved by rest 2, 3, 4.
- The symptoms of myasthenia gravis can vary widely among individuals, but common symptoms include:
- Muscle weakness
- Fatigue
- Drooping eyelids
- Double vision
- Difficulty speaking or swallowing
- Shortness of breath
- The severity of symptoms can also vary, with some people experiencing mild symptoms and others experiencing more severe symptoms that can interfere with daily activities 5, 6.
Treatment Options
- Treatment for myasthenia gravis typically involves a combination of medications and therapies, including:
- Acetylcholinesterase inhibitors, such as pyridostigmine, to improve muscle strength and reduce fatigue 2, 4.
- Corticosteroids, such as prednisone, to reduce inflammation and suppress the immune system 3, 6.
- Immunosuppressive therapies, such as azathioprine, to reduce the immune system's attack on the nervous system 3, 6.
- Plasmapheresis or intravenous immunoglobulin therapy to remove antibodies from the blood and reduce symptoms 2, 3, 5.
- In some cases, surgery, such as thymectomy, may be necessary to remove a tumor or abnormal tissue that is contributing to the symptoms 6.
Management and Prognosis
- With proper treatment, many people with myasthenia gravis can experience significant improvement in their symptoms and quality of life 2, 3, 4, 5, 6.
- However, the disease can be unpredictable, and symptoms can worsen over time, even with treatment 2, 3, 4, 5, 6.
- It is essential for people with myasthenia gravis to work closely with their healthcare provider to develop a personalized treatment plan and make lifestyle changes to manage their symptoms and improve their overall health 6.