ANP 652 13

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School

Grand Canyon University *

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Course

652

Subject

Medicine

Date

Apr 3, 2024

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docx

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Uploaded by PresidentKouprey3370

How can you differentiate a cholinergic crisis from a myasthenia crisis? A tensilon test , also called an edrophonium test, is a pharmacological test used for the diagnosis of certain neural diseases, especially myasthenia gravis. It is also used to distinguish a myasthenic crisis from a cholinergic crisis in individuals undergoing treatment for myasthenia gravis (Vanoli & Mantegazza, 2022). The myasthenic crisis should be differentiated from the cholinergic crisis with the edrophonium test . Administration of 2 mg of edrophonium will worsen the clinical symptoms of cholinergic crisis. The contrary is the case in myasthenic crisis (Vanoli & Mantegazza, 2022). A myasthenic crisis is a life-threatening exacerbation of myasthenia gravis that is defined as a worsening of myasthenic weakness requiring intubation or noninvasive ventilation (Sera et al., 2022). Myasthenic crises can involve the upper airway muscles, respiratory muscles, or a combination of both muscle groups. Both inspiratory and expiratory respiratory muscles can be affected, manifesting as dyspnea. One of the causes is infection. Lack of sleep, pregnancy, stress from trauma or surgery, some antibiotics, some neuromuscular blocking agents, and extreme temperature (Sera et al., 2022). The cholinergic crisis is a clinical condition that develops as a result of overstimulation of nicotinic and muscarinic receptors at the neuromuscular junctions and synapses. This is usually secondary to the inactivation or inhibition of acetylcholinesterase (AChE), the enzyme responsible for the degradation of acetylcholine (Sera et al., 2022). Management strategies for cholinergic crisis primarily involve supportive care and the administration of appropriate medications. Discontinuation of cholinergic medications, Supportive measures like fluid, oxygen, and administration of antidotes (Sera et al., 2022) References Farrugia, M. E., & Goodfellow, J. A. (2020). A practical approach to managing patients with myasthenia gravis-opinions and a review of the literature. Frontiers in Neurology , 11 , 1-16. https://doi.org/10.3389/fneur.2020.00604 Sera, T., Kusunoki, S., & Shime, N. (2022). Unexpected cholinergic crisis caused by distigmine bromide: A case report. Medicine , 101 (47), 1- 3. https://doi.org/10.1097/MD.0000000000031677 Vanoli, F., & Mantegazza, R. (2022). Antibody therapies in autoimmune neuromuscular junction disorders: Approach to myasthenic crisis and chronic management. Neurotherapeutics , 19 (3), 897–910. https://doi.org/10.1007/s13311-022-01181-3

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ANP 652 13

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