Medical Treatment Options
Pyridostigmine is an anticholinesterase inhibitor that works at the neuromuscular junction (NMJ). It prevents the breakdown of acetylcholine. Thus it allows acetylcholine to bind to more muscle receptors and create muscle contractions. Pyridostigmine does not alter myasthenia gravis disease, but provides temporary symptom improvement.
Myasthenia gravis is an autoimmune disease. Immunosuppressant medications work to lower the immune system response in order to prevent the immune attack on the NMJ, thereby limiting muscle fatigue. Common immunosuppressive medications used in myasthenia gravis include: Prednisone, Azathioprine, and Mycophenolate Mofetil.
While on immunosuppressant medication, care should be taken to limit exposure to colds and flus. Vaccinations should be up to date, including the flu and pneumonia vaccines. Practice good hand washing. You may need to follow-up frequently with your health provider to monitor certain blood tests.
Intravenous Immune Globulin
IVIG is an intravenous medication given through a small, peripheral catheter. IVIG binds to the antibodies in your bloodstream and then is filtered out of the body by the kidneys. During the infusion your heart rate and blood pressure are monitored. This medication is used for emergency situations when you have difficulty breathing or swallowing.
Plasmaphersis is a treatment that requires insertion of a large catheter. Your blood is then filtered through a machine to pull out proteins, which contain the antibodies. During the filtering process, your heart rate and blood pressure are monitored. This treatment is used for emergency situations when you have difficulty breathing or swallowing.
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