Page 2064 - Saunders Comprehensive Review For NCLEX-RN

CHAPTER 59

Neurological Medications

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Priority Concepts
Intracranial Regulation; Pain

I. Antimyasthenic Medications
A. Description
1. Antimyasthenic medications, also called
anticholinesterase medications, relieve muscle weakness
associated with myasthenia gravis by blocking
acetylcholine breakdown at the neuromuscular
junction.
2. These are used to treat or diagnose myasthenia gravis
or to distinguish cholinergic crisis from myasthenic
crisis.
3. Neostigmine bromide and pyridostigmine are used to
control myasthenic symptoms.
4. Edrophonium is used to diagnose myasthenia gravis
and to distinguish cholinergic crisis from myasthenic
crisis.
B. Medications (Box 59-1)

C. Side and adverse effects: Cholinergic crisis (Box 59-2)

D. Interventions

1. Assess neuromuscular status, including reflexes,
muscle strength, and gait.
2. Monitor the client for signs and symptoms of
medication overdose (cholinergic crisis) and
underdose (myasthenic crisis).
3. Instruct the client to take medications on time to
maintain therapeutic blood level, thus preventing
weakness, because weakness can impair the client’s
ability to breathe and swallow.
4. Instruct the client to take the medication with a small
amount of food to prevent gastrointestinal symptoms.
5. Instruct the client to eat a meal 45 to 60 minutes after
taking medications to decrease the risk for aspiration.

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