Myasthenia Gravis Care: Essential Tips for Patients and Caregivers

Myasthenia gravis (MG) is a chronic autoimmune neuromuscular disorder that causes weakness in the skeletal muscles. This condition can worsen under certain circumstances, such as upper respiratory infections, diarrhea, concurrent thyroid disease, pregnancy, fever, emotional stress, or the use of medications that affect the neuromuscular junction. Therefore, it's crucial for patients to take preventive measures to avoid these triggers.

Preventive Measures for Myasthenia Gravis Patients

Patients should take care to avoid colds and flu by dressing warmly in cold weather and practicing good hygiene. Maintaining proper dietary habits is essential to prevent gastrointestinal issues like diarrhea. It's also important to avoid overexertion, lack of sleep, and emotional fluctuations, as these can all contribute to disease flare-ups.

Medication Management and Drug Avoidance

Medication use must be carefully monitored. Several types of drugs can exacerbate myasthenia gravis symptoms and should be used with caution or avoided altogether. These include certain antibiotics like aminoglycosides and antifungal medications such as amphotericin B. Cardiovascular drugs like lidocaine and beta-blockers may also interfere with neuromuscular transmission.

Additionally, some antiepileptic drugs—such as phenytoin and ethosuximide—can worsen symptoms and should be avoided. Psychiatric medications like chlorpromazine, lithium carbonate, diazepam, and clonazepam require caution. Narcotic painkillers such as morphine and pethidine must be strictly avoided due to their potential to suppress respiration. Even some anti-rheumatic drugs, like chloroquine, should be used with care.

Managing Severe Symptoms and Complications

For patients experiencing severe symptoms, especially those with respiratory difficulties, proper airway management is critical. Regular chest physiotherapy and suctioning may be necessary to clear secretions and prevent complications like atelectasis or pneumonia.

Dysphagia (difficulty swallowing) is another common issue in advanced cases. In such situations, early initiation of nasogastric feeding can help prevent aspiration and malnutrition. Aspiration pneumonia is a serious complication that can significantly worsen the patient's condition, so careful feeding techniques and positioning are essential.

Additional Important Considerations

Other key points in managing myasthenia gravis include avoiding the use of soapsuds enemas, which can aggravate muscle weakness. Patients undergoing corticosteroid therapy should also be closely monitored for electrolyte balance, particularly potassium and calcium levels. Gastrointestinal protection, such as using proton pump inhibitors or H2 blockers, is also recommended to prevent steroid-induced gastritis.