Myasthenia gravis medical therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

The mainstays of medical therapy for myasthenia gravis are:

An oral anticholinesterase like pyridostigmine is usually the first drug in MG patients.(5) these drugs can reduce the degradation of Ach in the synaptic cleft.(7) limbs and bulbar muscles respond very well to these drugs but ocular symptoms including diplopia are resistance to these medications.(8) (manabe az treatment)

glucocorticoids: There are many studies supporting the beneficial effect of glucocorticoids like oral prednisone and pulsed intravenous (IV) methylprednisolone in MG patients. This group of drugs can improve the symptoms in almost 50 percent of patients.(6,7,8,11 chronic) the side effects of these drug are: Skin thinning and purpura(13), Cushingoid appearance and weight gain(4), cataracts and glaucoma(7), ischemic heart disease and heart failure(31), gastritis, ulcer formation, and gastrointestinal bleeding(48-49), menstrual irregularities in women and low fertility in both men and women(66-67) and psychiatric and cognitive symptoms(71).(manabe az avareze korton)
immunosuppressive drugs