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This Concept Map, created with IHMC CmapTools, has information related to: we in grave danger, Edrophonium (Enlon) Dosage in Case Patient Case Dosages 110 lb = 50 kg Neostigmine 0.1 mg/kg x (50 kg) = 5 mg , so 5 mg x (10mL/5mg) = 10 mL of neostigmine for initial/test dose, repeated after 5 min if required for the reversal of muscle relaxation So if positive, 0.5 mg/kg x (50kg) = 25 mg dose, so 25 mg x (1 tablet/15mg) = 1.6666666 with 15 mg tablets so the dose is 25 x 3= 75 mg/day. 5 tablets/day (orally) neostigmine tablets every 8 hours to treat myasthenia gravis Edrophonium 0.1mg/kg x (50 kg) = 5 mg, so 5 mg x (15mL/150mg) = 0.5 mL of edrophonium IV push, Right and Left Arm outstretched: If any trouble elevating arms 90°, and holding them in place How long can one hold arms up? longer than 9 seconds = Not myasthenia gravis, Acetylcholine esterase- breaks down acetylcholine into choline and acetate ???? Prevents generation of multiple, unnecessary action potentials in post-synaptic cells, Myasthenia Gravis Drug Therapy (Receptor) Quarternary AChE inhibitor, Normal (Healthy) ???? Acetylcholine esterase- breaks down acetylcholine into choline and acetate, Pyridostigmine (Mestinon) Uses Relief of muscle weaknes in MG, Rapid-acting AChE inhibitor Drug Name (Brand) Edrophonium (Enlon), Quarternary AChE inhibitor Drug Name (Brand) Pyridostigmine (Mestinon), Myasthenia Gravis Test Right and Left Arm outstretched: If any trouble elevating arms 90°, and holding them in place, 2 Potassium ions in and 3 Sodium ions out, causing depolarization Action potential propagates to neuromuscular junction Skeletal muscle contraction, Right and Left Arm outstretched: If any trouble elevating arms 90°, and holding them in place How long can one hold arms up? 0-9 seconds = Myasthenia gravis, Neostigmine (Prostigmin) Uses Relief of muscle weaknes in MG, Normal (Healthy) ???? ACh Binds to nicotinic receptor, ACh Binds to nicotinic receptor Opens sodium and potassium channels 2 Potassium ions in and 3 Sodium ions out, causing depolarization, Neostigmine (Prostigmin) Uses acute colonic pseudo-obstruction, Myasthenia Gravis Physiology Not healthy, Myasthenia Gravis Physiology Normal (Healthy), Hand Shake Test: Grip strength and sustaining grip Strength Weak and no lasting grip = Myasthenia gravis, Hand Shake Test: Grip strength and sustaining grip Strength Strong and lasting grip= Not myasthenia gravis, Edrophonium (Enlon) Uses Rapidly and Temporarily reduce muscle weakness