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As a result of cholinergic crisis, the muscles stop responding to the high synaptic levels of acetylcholine, leading to flaccid paralysis, respiratory failure, and other signs and symptoms reminiscent of organophosphate poisoning. Other symptoms include increased sweating, salivation, bronchial secretions along with miosis (constricted pupils).
In the treatment of organophosphate toxicity, cholinesterase reactivators such as Pralidoxime reactivate inhibited AChE at peripheral nicotinic receptors. Since AChE mediates effects on both nicotinic and muscarinic receptors, cholinesterase reactivators are co-administered with muscarinic antagonists, primarily atropine .
For people affected by cholinergic syndrome, atropine sulfate combined with an oxime is used to combat the effects of the acute OP poisoning. Diazepam is sometimes also administered if convulsions or muscle fasciculations begin. [16] The intermediate syndrome (IMS) appears in the interval between the end of the cholinergic crisis and the onset ...
Intravenous benzodiazepine is used as a first-line treatment for agitation. Cooling measures are employed if there is any significant hyperthermia. Activated charcoal is only given within one hour of anticholinergic ingestion. Physostigmine is given only if presenting both peripheral and central signs and symptoms of anticholinergic poisoning. [23]
Where an underlying neoplasm is the cause, treatment of this condition is indicated to reduce progression of symptoms. For cases without a known cause, treatment involves suppression of the immune system with corticosteroid treatment, intravenous immunoglobulin , immunosuppressive agents like rituximab , mycophenolate mofetil (Cellcept), or ...
Signs and symptoms in pregnant mothers tend to improve during the second and third trimesters. Complete remission can occur in some mothers. [ 45 ] Immunosuppressive therapy should be maintained throughout pregnancy, as this reduces the chance of neonatal muscle weakness, and controls the mother's myasthenia.
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Treatment of dysautonomia can be difficult; since it is made up of many different symptoms, a combination of drug therapies is often required to manage individual symptomatic complaints. In the case of autoimmune neuropathy, treatment with immunomodulatory therapies is done. If diabetes mellitus is the cause, control of blood glucose is ...