The nurse is teaching a patient who is newly diagnosed with myasthenia gravis about managing the disease. Which is important when teaching this patient about adverse effects of cholinesterase inhibitors?

a. "There are very few serious side effects associated with your medication."
b. "It is important to notify your provider if you have excessive saliva."
c. "If you experience urinary urgency, you may need to increase your dose."
d. "Excessive sweating is a minor side effect and will improve over time."


B
Accumulation of ACh at muscarinic receptors can result in excessive salivation, bradycardia, sweating, increased gastric secretions, increased tone and motility of the GI tract, and urinary urgency. These responses may have to be suppressed with atropine. In toxic doses, accumulation of ACh may produce depolarizing neuromuscular blockade with paralysis of respiratory muscles. Patients should be taught to report any of these symptoms to their provider.

Nursing

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