Patients with myasthenia gravis should be careful when taking some medications. Because some drugs can directly aggravate the disease, myasthenia gravis medications are contraindicated, and there are several types of drugs that need to be used with care or in accordance with the will.
Cardiovascular medications: anti-arrhythmic drugs, often used to prevent and treat arrhythmias, including procaine, quinidine, lidocaine, etc.; beta-adrenergic receptor blockers, including insulin, atenolol, vinblastine, betaxolol, indololol (insulin static), insulin yi, timolol, etc. Some elderly patients with myasthenia gravis are often combined with cardiovascular disease, so these drugs are often used, which should be used under the guidance of a neurologist.
Antibiotics: aminoglycoside antibiotics, including gentamicin, butylamine kanamycin, ethyl propoxycin, tobramycin, streptomycin, kanamycin, amikacin, etc.; tetracyclines, including tetracycline, oxytetracycline, deoxytetracycline, dimethylaminotetracycline, etc. These are usually oral tablets, commonly used in respiratory and gastrointestinal tract infections, and their possibility of inducing exacerbation of myasthenia gravis is relatively small; quinolones These drugs are commonly used in the treatment of gastrointestinal and urinary tract infections, and may also induce myasthenia gravis. The antibiotics that have not been found to aggravate myasthenia gravis are: penicillin, erythromycin, chloramphenicol, spiramycin, dactinomycin, vanguardomycin, and other cephalosporin antibiotics. Therefore, we recommend that when choosing antibiotics for patients with myasthenia gravis, penicillin antibiotics, cephalosporin antibiotics and chloramphenicol are preferred.
Narcotic drugs: Many narcotic drugs can directly aggravate myasthenia gravis. Myorelaxants (arrow toxin, D-cartridge arrow toxin base) can lead to respiratory muscle weakness causing death by asphyxia and are prohibited drugs for myasthenia gravis; membrane stabilizers (quinine, quinidine, acetonide endoureas, procainamide), depolarizing drugs (decamethoprim, butanediol choline) and other conduction blockers at the neuromuscular junction should be used with caution; valium, morphine, tranquilizers and other respiratory depressants should also be used with caution.
Hormonal drugs: prednisone, methylprednisolone, dexamethasone and other drugs are the most commonly used drugs for the treatment of myasthenia gravis. However, changes in the condition should be closely observed in the early stage of hormone application, because there is often a transient aggravation of symptoms at this time, and individual patients may even develop myasthenia gravis (i.e., causing respiratory muscle weakness, which can cause asphyxia leading to death in severe cases). It is recommended that during the first three weeks of hormone treatment for myasthenia gravis, it is best to be hospitalized in a large hospital with ventilator conditions to avoid danger.
Antipsychotic drugs: This group of drugs includes chlorpromazine, clozapine, haloperidol (trifloxystrobin), isocarbohydrazide, phencyclidine, etc.
A. Notes on medication for patients with myasthenia gravis.
1. Drugs that aggravate or induce myasthenia gravis include.
(1) Morphine-based painkillers.
(2) Narcotics, such as ketamine, prilamine, lidocaine, procaine, etc.
(3) Muscle relaxants, such as arrowroot and D-barrel arrowroot bases, trimethoprim and decamethoprim, etc.
(4) Anti-rheumatic drugs, such as D-cyprinolamine.
(5) Adrenergic blocking agents, such as insulin, insulin, insulin, etc.
(6) Depolarizing drugs and membrane stabilizers such as quinine, quinidine, and procainamide.
(7) Anti-epileptic drugs, such as phenytoin sodium, trimethoprim and carbamazepine, etc.
(8) Antipsychotics, such as chlorpromazine, phenelzine and promethazine
(9) Sedative sleeping drugs, such as chloral hydrate, barbiturates sleeping drugs and tranquilizers. Now we also found that cold medicines containing paracetamol can also cause the aggravation of myasthenia gravis symptoms.
(10) Snake venom preparations.
(11) Botulinum toxin.
(12) Others, such as oxytocin, peptidase, tetanus antitoxin and sulfonamides.
2. Antibiotics that aggravate or induce myasthenia gravis.
(1) Polymyxins, including polymyxins A, B and mucin.
(2) Tetracycline family antibiotics, including tetracycline, chlortetracycline, oxytetracycline and doxycycline.
(3) Aminoglycoside antibiotics, including gentamicin, streptomycin, kanamycin, barongomycin, tobramycin, fotemycin A, ethyl zithromax and guantanamycin.
(4) Others, including viomycin, lincomycin, clindamycin, vancomycin and bacitracin.
3, patients with myasthenia gravis may choose antibiotics.
(1) Penicillin antibiotics, such as penicillin, ampicillin, carbenicillin.
(2) Cephalosporin antibiotics, such as pioneer must, ceftazidime, cefotaxime sodium.
(3) macrolide antibiotics, such as erythromycin, leucomycin, azithromycin, cross-spectin, etc.
(4) Chloramphenicol.