2019 Dec;25(6):1767-1784. doi: 10.1212/CON.0000000000000800.Pasnoor M, Wolfe GI, Nations S, Trivedi J, Barohn RJ, Herbelin L, McVey A, Dimachkie M, Kissel J, Walsh R, Amato A, Mozaffar T, Hungs M, Chui L, Goldstein J, Novella S, Burns T, Phillips L, Claussen G, Young A, Bertorini T, Oh S.Muscle Nerve. Fifteen international experts in MG participated in the consensus process, which used a simple consensus to develop preliminary definitions and the RAND/UCLA Appropriateness Method to quantify agreement on treatment guidance statements for seven topics: symptomatic and immunosuppressive treatment, intravenous immunoglobulin and plasma exchange, impending and manifest myasthenic crisis, thymectomy, juvenile MG, MG with muscle-specific tyrosine kinase antibodies, and MG in pregnancy.
2020 Jun 12;11:554. doi: 10.3389/fneur.2020.00554.
Atropine is contra-indicated in myasthenia gravis (except to reduce muscarinic side-effects of anticholinesterases). doi: 10.1136/bcr-2014-207708.Continuum (Minneap Minn).
2010 Mar;41(3):370-4. doi: 10.1002/mus.21533.Front Neurol. Neonatal myasthenia develops in 12% of babies born to women who have myasthenia gravis. During the second operation, atropine, rather than glycopyrrolate, was used to prevent the fetal muscarinic effects of neostigmine. Most of the studies involving quaternary ammonium anticholinesterases in pregnancy involve patients suffering from myasthenia gravis. pancuronium) Usually reversed with atropine 20 micrograms/kg IV followed by one (or occasionally 2) 40 microgram/kg/dose of neostigmine.
2020 Mar;8(5):250. doi: 10.21037/atm.2020.01.79.Xu W, Ren M, Ghosh S, Qian K, Luo Z, Zhang A, Zhang C, Cui J.Mediators Inflamm. Most of the studies involving quaternary ammonium anticholinesterases in pregnancy involve patients suffering from myasthenia gravis. 3rd edition. This type of myasthenia gravis is called antibody-negative myasthenia gravis. Striated cardiac muscle can be a target for immune attack manifesting as heart failure, arrhythmia, and sudden death. A task force of the Myasthenia Gravis Foundation of America recently published a formal consensus statement intended to be a treatment guide for clinicians caring for myasthenia gravis (MG) patients worldwide. Edited by Chestnut DH. Edited by Boreus L. New York, Raven, 1973, pp 1-26.Roberts JB, Thomas BH, Wilson A: Placental transfer of pyridostigmine in the rat. (Lattin) Professor, Department of Biopharmaceutical Sciences, College of Pharmacy.Received from the University of Arkansas for Medical Sciences Campus, Little Rock, Arkansas. Search for other works by this author on: Fetal heart rate immediately decreased to the range of 90-110 beats/min after administration of neostigmine and glycopyrrolate. Sanders DB, Wolfe GI, Benatar M, Evoli A, Gilhus NE, Illa I, Kuntz N, Massey JM, Melms A, Murai H, Nicolle M, Palace J, Richman DP, Verschuuren J, Narayanaswami P.Neurology. The nurse notes ptosis of both eyelids and observes that the patient has difficulty swallowing. Search for other works by this author on: Clipboard, Search History, and several other advanced features are temporarily unavailable. But it should be noted that 15–20% of patients with myasthenia gravis experience at least one crisis in their lives. 2016 Jul 26;87(4):419-25. doi: 10.1212/WNL.0000000000002790. presented two case reports and reviewed the etiology, diagnosis, course, and treatment of pregnant patients with myasthenia gravis and … Shnider and Levinson recommended, "Neostigmine, when used to reverse the effects of muscle relaxants, should be administered slowly and be preceded by adequate doses of atropine."
Am J Obstet Gynecol 1979; 135:691-7.Eden RD, Gall SA: Myasthenia gravis and pregnancy: A reappraisal of thymectomy. doi: 10.1097/MD.0000000000017563. 2020 May 27;11:776. doi: 10.3389/fimmu.2020.00776. Left uterine displacement was increased, and the fetal heart rate gradually returned to 120 beats/min. Preoperatively, the fetal heart rate was 153 beats/min but varied between 115 and 130 beats/min intraoperatively. Submitted for publication May 19, 1995.
Atropine is a lipid-soluble tertiary amine and would be expected to cross the placenta in the form of the free base. Hon EH, Bradfield AH, Hess OW: The electronic evaluation of the fetal heart rate: V. The vagal factor in fetal bradycardia.
Mestinon is also used in military personnel who have been exposed to nerve gas.
Am J Obstet Gynecol 1961; 82:291-300.Proakis AG, Harris GB: Comparative penetration of glycopyrrolate and atropine across the blood-brain and placental barriers in anesthetized dogs. The most important aspect of emergent management of myasthenia gravis is the detection and treatment of the myasthenic crisis. McNall and Jafarnia presented five case reports and discussed management of la Chambers et al. She required open reduction of a fractured elbow. Am J Obstet Gynecol 1965; 92:518-25.Chambers DC, Hall JE, Boyce J: Myasthenia gravis and pregnancy.