A patient who has myasthenia gravis (MG) presents to the emergency department with abrupt onset of increased muscle weakness and difficulty swallowing. An attempt to distinguish worsening of the MG symptoms from overdose of the patient's prescribed anticholinergic is planned. What medications should the nurse obtain for use in this procedure? Note: Credit will be given only if all correct choices
and no incorrect choices are selected. Standard Text: Select all that apply.
1. Donepezil (Aricept)
2. Pyridostigmine (Mestinon)
3. Neostigmine (Prostigmin)
4. Edrophonium (Edrophonium Injectable)
5. Atropine (Atropine Injectable)
4,5
Rationale 1: Donepezil (Aricept) is prescribed for the treatment of Alzheimer's disease and would not be used in this situation.
Rationale 2: Pyridostigmine (Mestinon) is prescribed for the treatment of MG but would not be used to determine if this patient is having increased symptoms or excessive medication.
Rationale 3: Neostigmine (Prostigmin) is prescribed for the treatment of MG but would not be used to determine if this patient is having increased symptoms or excessive medication.
Rationale 4: Edrophonium (Edrophonium Injectable) is given as a test dose. If muscular symptoms improve, the patient is having a myasthenic crisis.
Rationale 5: Atropine (Atropine Injectable) is given if the test results in a cholinergic crisis.
Global Rationale: Edrophonium (Edrophonium Injectable) is given as a test dose. If muscular symptoms improve, the patient is having a myasthenic crisis. Atropine (Atropine Injectable) is given if the test results in a cholinergic crisis. Donepezil (Aricept) is prescribed for the treatment of Alzheimer's disease and would not be used in this situation. Pyridostigmine (Mestinon) is prescribed for the treatment of MG but would not be used to determine if this patient is having increased symptoms or excessive medication. Neostigmine (Prostigmin) is prescribed for the treatment of MG but would not be used to determine if this patient is having increased symptoms or excessive medication.
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