exaplian plz --- why not atropine - newboy

[ArchivalUser]

A A 45-year-old woman with a history of myasthenia gravis presents with severe, generalized weakness. There has been no change in her pyridostigmine dose. A Tensilon test is performed which results in increased muscle weakness. Of the following, which is the MOST IMPORTANT treatment consideration?
*a. Closely monitor respiratory status
b. Give atropine and titrate to symptoms
c. Increase patient pyridostigmine
d. Initiate pralidoxime treatment
e. Prepare for possible plasmapharesis

[ArchivalUser]

Since the lady has severe generalized weakness, the primaary concern wud be to watch for respiratory muscle weakness, since if that is present, one may need to consider respy support in the form of Endotrach Intubn. One has to remember the ABCs of any emergency, and here, "breathing" wud be more imp to assess. If she has good respn, then one may consider atropine etal.

[ArchivalUser]

newboy
there is one similar case in UW, which asks what you do next, and the ans is intubate, as b2 said, the basic idea here is ABC, not the continued treatment.

[ArchivalUser]

ABC first.

[ArchivalUser]

ATROPINE WILL REVERSE MUSCARINIC EFFECTS NOT NICOTINIC WHICH ARE PRESENT AT NMJ