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CH 44 Guillain Barre and Myasthenia Gravis

Terms in this set (25)

Guillain-Barre Syndrome (GBS)
acute inflammatory disorder the affects the axons and myelin of the peripheral nervous system; causes rapidly progressing paralysis
Ascending paralysis
occurs in demyelinating GBS; symptoms typically begin in the legs and spread to the arms and upper body
reverse order of ascending paralysis
how does healing occur in GBS
1. Acute or Initial Period- onset of first s/s and ends when no further deterioration occurs
2. Plateau Period- several days to 2 weeks
3. Recovery Phase- gradually over 4-6 months and could be up to 2 years
3 stages of acute course of GBS:
muscle weakness that affects mobility
Most pts with GBS will report a sudden onset of
loss of reflexes in the arms and legs
Common s/s of GBS
1. increased protein
2. normal cell count
- may not be noted until after 1-2 weeks of illness
Pts CSF that have GBS will show these 2 things:
1. Plasmapheresis
2. Immunoglobulin - safer and always available
2 main tx options for pts with GBS:
Myasthenia Gravis (MG)
Progressive, acquired autoimmune disease characterized by muscle weakness; can be ocular or generalized; caused by distorted acetylcholine receptors causing no muscle contraction
ocular muscle disturbances
most patients with myasthenia gravis initially present with reports of
Cholinergic drugs
Myasthenia Gravis can be immediately confirmed according to the pts response to
thyroid
- can cause thyrotoxicosis
these levels should be tested in pts with Myasthenia Gravis
Tensilon
med used for MG that inhibits the breakdown of acetylcholine and increases its availability for excitation; causes muscle excitability
Myasthenia crisis
-administer more meds if needed
If pts show improvement in muscle tone after administration of Tensilon then you can make what diagnosis
Cholinergic crisis
- pt is overmedicated and needs antidote
if pts weakness is more severe after administration of Tensilon then you can make what diagnosis
Atropine Sulfate
Antidote for cholinergic crisis
1. V-Fib
2. Cardiac Arrest
Tensilon can cause these to adverse reactions to occur so you need to make sure to have antidote readily available along with emergency equipment
Cholinesterase inhibitors
First line management drugs for pts with MG; prevent decrease of ACH; improve muscle strength and nerve responses
Pyridostigmine (Mestinon)
Drug of choice for cholinesterase inhibitors for pts with MG
1. sudden increase in weakness
2. hyper salivation
3. sweating
4. increased bronchial secretions
S/S of cholinesterase crisis: (4)
1. Bronchospasms
2. Bradycardia
Cholinesterase inhibitors can cause these 2 life threatening symptoms:
Myasthenic crisis
an exacerbation of the myasthenic symptoms caused by undermedication with anticholinesterases
Cholinergic crisis
an acute exacerbation of muscle weakness caused by overmedication of anti cholinesterase drugs
Anticholinesterase
Do NOT give these drugs to pts on a vent because they increase respiratory secretions
rest
- repetitive movement can cause a crisis
This is a critical intervention for pts with MG
THIS SET IS OFTEN IN FOLDERS WITH...