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This Concept Map, created with IHMC CmapTools, has information related to: Week 13 (11) Myasthenia Gravis, Smooth Muscle (N2 or NN) Symptoms "droopy" eyelid/weakened facial expressions, Inhibition of ACh-esterase activity, increasing [ACh] Saturates leftover receptors with ACh Nicotinic Receptors, substrate of ACh, Trouble swallowing food if not chewed well Correlates with Difficulty swallowing/breathing, Neostigmine (Prostigmine) Response occurs in 10-15 minutes, Patient: 20 yo F Weight: 110lbs (50kg) Height: 5'6 symptoms Arms and legs tire rapidly with exertion, Trouble swallowing food if not chewed well Correlates with "droopy" eyelid/weakened facial expressions, Experiences severe muscle fatigue & weakness (Chronic) Quickly diagnosed by "Handshake test", Neostigmine (Prostigmine) Pharmacological treatments Inhibition of ACh-esterase activity, increasing [ACh], Neostigmine (Prostigmin 15mg) 0.5mg/kg Oral 25mg (1 and 2/3 tablet) every 8 hours, 25mg (1 and 2/3 tablet) every 8 hours Daily Dose 75mg (5 tablets), 5mg (10mL) of 5mg/10ml vial May repeat After 5 minutes if required for reversal of muscle relaxation, In 80% of MG, pathology occurs by ACh-receptor antibodies destroying Nicotinic Receptors, substrate of ACh, Patient: 20 yo F Weight: 110lbs (50kg) Height: 5'6 symptoms Droopy eyelids for about 3 months, Patient: 20 yo F Weight: 110lbs (50kg) Height: 5'6 symptoms Trouble swallowing food if not chewed well, Patient: 20 yo F Weight: 110lbs (50kg) Height: 5'6 Maintenance dose Neostigmine (Prostigmin 15mg) 0.5mg/kg, Edrephonium IV 5mg (0.5 mL) of 150mg/15 mL vial, Edrephonium Pharmacological treatments Inhibition of ACh-esterase activity, increasing [ACh], Inhibition of ACh-esterase activity, increasing [ACh] Cholinergic crisis Occurs with over-inhibition of ACh-esterase, causing a surplus of ACh., Pyridostigmine (Mestinon) Response occurs in 10-15 minutes, Arms and legs tire rapidly with exertion Correlates with Experiences severe muscle fatigue & weakness (Chronic)