The patients all received conventional systemic therapy including IVIG, pyridostigmine
, and steroids.
Her ocular and bulbar symptoms, as well as her limb weakness improved with intravenous immunoglobulin treatment, pyridostigmine
and corticosteroids therapy.
In addition, pyridostigmine
bromide was used as a prophylactic agent against potential nerve agent exposure (NASEM, 2016).
We consequently made a diagnosis of MG and acute leptospirosis and initiated treatment with pyridostigmine
bromide and intravenous ceftriaxone.
The other medications such as neostigmine, pyridostigmine
, cisapride, trimebutine maleate, metoclopramide, dom-peridone, and laxatives were given according to the standard pediatric doses.
We started oral pyridostigmine
0.5 mg/kg/day every 6 hours and gradually increased the dose to 1 mg/kg/day every 6 hours over several days.
Anticholinesterase drugs are the first-line approach for managing symptoms, (5) with pyridostigmine
bromide (mestinon) the most commonly used.
(13,16) Midodrine can be used as monotherapy or in combination with fludrocortisone or, in low dosages, with pyridostigmine
. (19,31) Adverse events include urinary urgency or retention (6%), piloerection (13%), pruritus/tingling (mostly of scalp; 9% to 10%), and chills (5%).
Acute Behavioral Toxicity of Pyridostigmine
or Soman in Primates.
Comparison of pyridostigmine
and bisacodyl in the treatment of refractory chronic constipation.
bromide (90 mg/day) treatment was started for the patient.