Background: The antagonistic actions of anticholinesterase drugs
on non-depolarizing muscle relaxants are theoretically related to the activity of acetylcholinesterase (AChE) in the neuromuscular junction (NMJ).
are routinely administered at the end of surgery to antagonise any residual effect of nondepolarising neuromuscular blocking agents.
After surgery, patients were transferred to the intensive care unit for elective overnight ventilation; midazolam and fentanyl infusions were discontinued early morning of the following day, no anticholinesterase drugs
were added, and patients received their normal myasthenic therapy via the nasogastric tube.
These variants are more likely to affect the duration of response when present with other factors that influence BChE activity, such as a qualitative BChE variant, pregnancy, and anticholinesterase drugs
Conventional treatment involves the use of steroid immune system suppressers such as prednisone, and anticholinesterase drugs
, usually pyrodostigmine.
A nondepolarising neuromuscular blocking agent is an alternative, however their disadvantages include long duration of action, less effectiveness for deep neuromuscular blocking and muscarinic side-effects of anticholinesterase drugs
(3,4) when they are used for reversal.
Both trials included patients who had been stable on anticholinesterase drugs
for at least 3 months prior to the study.
Table I Dental Hygiene Discussion Topics for Patients with Myasthenia Gravis * * Importance of avoiding exacerbation of MG by obtaining regular and frequent recare appointments to prevent oral infection * Scheduling dental hygiene appointments in the mid morning * Avoiding drugs that can cause muscle weakness and exacerbate MG * Taking anticholinesterase drugs
on time, as ordered by the MD, and 1 1/2 hour's before the dental hygiene appointment * Alertness to signs of myasthenic crisis and cholinergic crisis * Necessity of prompt treatment of oral disease and infection * Stress reduction strategies Adapted from Armstrong S.
Nice is recommending that the anticholinesterase drugs
( Aricept, Exelon and Reminyl ( should only be available for people in the moderate stages of the disease.
They are recommending that the anticholinesterase drugs
(Aricept, Exelon and Reminyl) should only be available for people in the moderate stages of Alzheimer's disease.
These costs can be much lower if anticholinesterase drugs
are received in the early stages of Alzheimer's.
The administration of these anticholinesterase drugs
focused attention on the neuromuscular junction in myasthenia gravis patients.