Related Experiment Video

Updated: May 20, 2025

A Computerized Test Battery to Study Pharmacodynamic Effects on the Central Nervous System of Cholinergic Drugs in Early Phase Drug Development
07:02

A Computerized Test Battery to Study Pharmacodynamic Effects on the Central Nervous System of Cholinergic Drugs in Early Phase Drug Development

Published on: February 11, 2019

9.8K

Effect of the Administration of Cautionary Drugs on the Risk of Worsening Myasthenia Gravis: A Retrospective Matched

Hee Jo Han1, Seung Woo Kim1, Myeongjee Lee2

  • 1Department of Neurology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.

Yonsei Medical Journal
|March 26, 2025
PubMed
Abstract

Insights

Certain medications can worsen myasthenia gravis (MG). This study found that administering cautionary drugs significantly increases the risk of MG clinical worsening in patients.

Area of Science:

  • Neurology
  • Clinical Pharmacology

Background:

  • Myasthenia gravis (MG) is a chronic autoimmune neuromuscular disease.
  • The impact of specific medications on MG exacerbations is not well-established.

Purpose of the Study:

  • To evaluate the risk of clinical worsening in myasthenia gravis patients following exposure to cautionary drugs.
  • To determine if certain medications precipitate MG exacerbations.

Main Methods:

  • Retrospective case-control study of 2002 MG patients (2007-2020).
  • Compared MG worsening risk in 220 patients exposed to cautionary drugs versus 220 matched non-exposed patients.
  • Risk period defined as 6 months post-drug exposure.

Main Results:

  • 27.6% of MG patients were exposed to cautionary drugs, most commonly neuromuscular blocking agents and beta-blockers.
  • The incidence of clinical worsening was significantly higher in exposed patients (14.1%) versus non-exposed (3.6%).
  • Cautionary drug exposure increased the odds of MG worsening by 4.09 times (OR=4.09, p<0.001).

Conclusions:

  • Administration of cautionary drugs is associated with an increased risk of clinical worsening in myasthenia gravis.
  • Healthcare providers must exercise caution when prescribing potentially exacerbating medications to MG patients.
Keywords:
Myasthenia gravisadverse drug reactionautoimmune diseasemyasthenic crisis

More Related Videos

Antigenic Liposomes for Generation of Disease-specific Antibodies10:31

Antigenic Liposomes for Generation of Disease-specific Antibodies

Published on: October 25, 2018

12.3K
A Machine Learning Approach to Design an Efficient Selective Screening of Mild Cognitive Impairment12:18

A Machine Learning Approach to Design an Efficient Selective Screening of Mild Cognitive Impairment

Published on: January 11, 2020

7.4K

Related Concept Videos

Myasthenia Gravis: Overview and Treatment01:20

Myasthenia Gravis: Overview and Treatment

Myasthenia gravis is a neuromuscular transmission disorder characterized by weakness and increased fatigability of skeletal muscles. It is an autoimmune disease affecting approximately one in 2000 people, where antibodies against the α1 subunit of nicotinic acetylcholine receptors are produced.
These antibodies interfere with the function of the nicotinic receptors in three ways: by binding to the receptor and disrupting acetylcholine binding; by causing cross-linking of receptors which...
1.0K
Myasthenia Gravis: Diagnostic Tests01:15

Myasthenia Gravis: Diagnostic Tests

Myasthenia gravis is an autoimmune condition affecting neuromuscular transmission, causing generalized weakness in skeletal muscles. Initial diagnoses rely on patients' signs, symptoms, and medical history. The challenge lies in distinguishing myasthenia from other muscular dystrophies. An important diagnostic feature is the significant improvement of symptoms after administering anticholinesterase inhibitors.
The edrophonium test is a diagnostic tool for myasthenia gravis. It involves...
581
Indirect-Acting Cholinergic Agonists: Pharmacological Actions01:30

Indirect-Acting Cholinergic Agonists: Pharmacological Actions

Indirect-acting cholinergic agonists, also known as anticholinesterases, exert their pharmacological effects by enhancing cholinergic transmission in various body parts, including the neuromuscular junction, autonomic cholinergic synapses, and the brain.
At the neuromuscular junction, these agents work by inhibiting the breakdown of acetylcholine, allowing it to remain bound to the receptor and bind to nearby receptors. This process leads to repetitive firing of the endplate, causing muscle...
588
Pharmacovigilance01:19

Pharmacovigilance

Post-marketing surveillance is a critical component of pharmaceutical regulation, often uncovering unanticipated adverse drug reactions (ADRs) once a drug is widely used over an extended period.
This process, termed pharmacovigilance, aims to detect, evaluate, and minimize harmful effects related to medication use. The data collection for pharmacovigilance depends on spontaneous reporting systems, where healthcare professionals or patients voluntarily report suspected ADRs.
In some cases, there...
761
Anticholinesterase Agents: Poisoning and Treatment01:26

Anticholinesterase Agents: Poisoning and Treatment

Anticholinesterases, also known as cholinesterase inhibitors, work by blocking the breakdown of acetylcholine, leading to its accumulation in the synaptic cleft. This accumulation indirectly enhances both muscarinic and nicotinic actions. These agents are classified as reversible or irreversible based on their mechanism of action.     
Irreversible agents form a strong bond with the cholinesterase enzyme, making it inactive. The breakdown of the phosphorylated enzyme is...
763
Skeletal Muscle Relaxants: Adverse Effects01:21

Skeletal Muscle Relaxants: Adverse Effects

Skeletal muscle relaxants are widely used for muscle paralysis and relieving pain following any muscle injury or stiffness. However, depending on the drug type, they can have adverse effects that range from mild to severe. Usually, nondepolarizing neuromuscular blockers have minimal side effects. For example, drugs like d-tubocurarine, cisatracurium, and rocuronium cause hypotension, whereas drugs like baclofen, when stopped abruptly, can lead to the recurrence of spastic conditions.
Unlike...
325