MYASTHENIA GRAVIS-MANAGEMENT

SUMMARY

1. IVIG or plasmapheresis (for myasthenic crisis only because duration of action is very short)

2. Steroids

3. Symptomatic mgm: anti-cholinesterase agents (pyridostigmine)

4. Immune-modulators in patients uncontrolled on pyridostigmine (steroids, cyclosporine, mycophenolate)

5. Thymectomy (takes years to see effects, but definitely perform in patients with thymoma) improves long-term prognosis

6. Avoid harmful medications

7. Longer term mgm: azathioprine (can take 6 months to take effect), other steroid sparing agents

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].