Treatment of myasthenia gravis

Many people may not have a deep understanding of the disease called myasthenia gravis, and do not know how to treat and prevent myasthenia gravis in life. In order to help everyone make up for the lack of medical knowledge, the article introduces us to several common treatments, such as thymectomy. Now let us learn about the treatment of myasthenia gravis so that we can better treat this disease in our lives.

For less common diseases, we need to understand their causes and treatment options, which can help us better understand the treatment methods of myasthenia gravis in our lives. The treatment of myasthenia gravis still requires us to listen to the doctor's advice during the treatment process.

1. Treatment options

(1) The first choice is thymectomy. If the condition worsens significantly after surgery, it can be supplemented with plasma exchange, high-dose immunoglobulin, adrenal corticosteroids, and cholesterase inhibitors.

(2) Secondary option: Patients with severe conditions who cannot undergo thymectomy can be treated with plasma exchange or high-dose immunoglobulin combined with adrenal corticosteroids, and gradually transitioned to corticosteroids alone. Thymectomy is performed after the condition improves and stabilizes for 2 months. The original dose is maintained for 2 months after surgery, and then the dose is slowly reduced for 2 to 4 years until it is discontinued.

(3) Three options: For MG patients who cannot or refuse thymectomy, plasma exchange or high-dose immunoglobulin are the first choice for critically ill patients, and corticosteroid treatment is the first choice for non-critically ill patients. During the process of reducing the dose of corticosteroids, other immunosuppressive drugs such as azathioprine can be added in appropriate amounts to reduce or alleviate the rebound phenomenon.

(4) Option 4: MG patients who refuse or are unable to undergo thymectomy and who refuse or are unable to tolerate corticosteroid treatment can be treated with immunosuppressive drugs such as cyclophosphamide.

2. Main treatment methods

(1) Cholesterase inhibitors: commonly used are neostigmine, pyridostigmine bromide, and ambenchloramine (enzyme inhibitor). Pyridostigmine bromide is the most commonly used drug with fewer side effects. The starting dose for adults is 60 mg orally, once every 4 hours. The dosage can be increased according to clinical manifestations. If the patient has difficulty eating, the medication can be taken 30 minutes before meals. If the patient has difficulty walking in the morning, 180 mg of long-acting pyridostigmine bromide can be taken before getting up. Its muscarine-like side effects include abdominal pain, diarrhea, nausea, vomiting, salivation, increased bronchial secretions, tearing, pupil constriction and sweating. Pre-administration of 0.4 mg of atropine can relieve its muscarine symptoms, but an overdose of atropine can cause mental symptoms. Start with a small dose and gradually increase the dose until muscle strength improves and you can maintain eating and daily activities, to avoid drug overdose. To relieve side effects such as abdominal pain and drooling, a small amount of atropine can be taken at the same time. In addition, long-term abuse of cholesterase inhibitors should be prevented to avoid hindering the repair of nAchR.

In order to help everyone better understand the treatment methods of myasthenia gravis, we hope that everyone can read more relevant treatment knowledge and communicate more with friends in daily life. This will help us better understand the disease of myasthenia gravis. At the same time, for the health of our family and friends, we hope that everyone can learn more about the treatments of common diseases.