{"id":274,"date":"2017-11-18T10:02:28","date_gmt":"2017-11-18T13:02:28","guid":{"rendered":"http:\/\/www.tomiozzo.med.br\/?p=274"},"modified":"2017-11-18T10:08:50","modified_gmt":"2017-11-18T13:08:50","slug":"miastenia-gravis-e-medicamentos","status":"publish","type":"post","link":"https:\/\/www.tomiozzo.med.br\/?p=274","title":{"rendered":"Miastenia Gravis e Medicamentos"},"content":{"rendered":"

A miastenia gravis \u00e9 uma doen\u00e7a autoimune caracterizada pelo ataque aos receptores de acetilcolina nos m\u00fasculos. Este receptor \u00e9 respons\u00e1vel pelo in\u00edcio da contra\u00e7\u00e3o muscular, sendo assim o paciente com a doen\u00e7a desenvolve uma redu\u00e7\u00e3o importante na for\u00e7a muscular.<\/span><\/p>\n

Sabe-se que diversos medicamentos podem influenciar a contra\u00e7\u00e3o muscular, sendo por reduzir diretamente a for\u00e7a e velocidade de contra\u00e7\u00e3o ou por interferirem na comunica\u00e7\u00e3o dos neur\u00f4nios com o m\u00fasculo. Como o paciente com miastenia j\u00e1 possui essa dificuldade de comunica\u00e7\u00e3o neuro-muscular, alguns medicamentos s\u00e3o contra-indicados por poderem piorar os sintomas da doen\u00e7a.<\/span><\/p>\n

Abaixo, encontra-se uma lista de medicamentos a serem evitados no paciente miast\u00eanico:<\/span><\/p>\n

\n
\n
Analg\u00e9sicos<\/strong><\/span>
\n Cetamina<\/span>
\n Lidoca\u00edna<\/span>
\n Morfina<\/span>
\n Antiarr\u00edtmicos<\/strong><\/span>
\n Acebutol<\/span>
\n Atenolol<\/span>
\n Betaxolol<\/span>
\n Carvedilol<\/span>
\n Esmolol<\/span>
\n Labetalol<\/span>
\n Metoprolol<\/span>
\n Nadolol<\/span>
\n Oxprenolol<\/span>
\n Pindolol<\/span>
\n Practolol<\/span>
\n Procainamida<\/span>
\n Propranolol<\/span>
\n Quinidina<\/span>
\n Quinino<\/span>
\n Sotalol<\/span>
\n Timolol<\/span>
\n Verapamil<\/span>
\nAnticolin\u00e9rgicos<\/strong><\/span>
\n Atropina<\/span>
\n Escopolamina<\/span>
\n Ipratr\u00f3pio<\/span>
\n Timoptol<\/span>
\n Triexifenidil<\/span><\/div>\n
Anticonvulsivantes<\/strong><\/span>
\n Carbamazepina<\/span>
\n Etossuximida<\/span>
\n Fenito\u00edna<\/span>
\n Fenobarbital<\/span>
\n Tiopental<\/span>
\n Antiinfecciosos<\/strong><\/span>
\n Amicacina<\/span>
\n Azitromicina<\/span>
\n Canamicina<\/span>
\n Ciprofloxacino<\/span>
\n Clindamicina<\/span>
\n Cloroquina<\/span>
\n Colistina<\/span>
\n Eritromicina<\/span>
\n Estreptomicina<\/span>
\n Gentamicina<\/span>
\n Levofloxacino<\/span>
\n Moxifloxacino<\/span>
\n Neomicina<\/span>
\n Norfloxacino<\/span>
\n Ofloxacino<\/span>
\n Perfloxacino<\/span>
\n Piperazina<\/span>
\n Polimixina<\/span>
\n Telitromicina<\/span>
\n Tobramicina<\/span><\/div>\n
Psicof\u00e1rmacos<\/strong><\/span>
\n Alprazolam<\/span>
\n Amitriptilina<\/span>
\n Anfetamina<\/span>
\n Carbonato de L\u00edtio<\/span>
\n Clonazepam<\/span>
\n Clorpromazina<\/span>
\n Clozapina<\/span>
\n Diazepam<\/span>
\n Droperidol<\/span>
\n Haloperidol<\/span>
\n Imipramina<\/span>
\n Midazolam<\/span>
\n Oxipertina<\/span>
\n Periciazina<\/span>
\n Pimozida<\/span>
\n Proclorperazina<\/span>
\n Risperidona<\/span>
\n Sulpirida<\/span>
\n Relaxantes musculares<\/strong><\/span>
\n Atrac\u00fario<\/span>
\n Baclofeno<\/span>
\n Cisatrac\u00fario<\/span>
\n Dantrolene<\/span>
\n Pancur\u00f4nio<\/span>
\n Succinilcolina<\/span>
\n Toxina botul\u00ednica<\/span>
\n Tubocurarina<\/span><\/div>\n
Outros<\/strong><\/span>
\n Colchicina<\/span>
\n Iodo<\/span>
\n Levocarnitina<\/span>
\n Levonorgestrel<\/span>
\n Magn\u00e9sio<\/span>
\n Nicotina<\/span>
\n Penicilamina<\/span>
\n Prometazina<\/span><\/div>\n<\/div>\n<\/div>\n

 <\/p>\n

Estas s\u00e3o medica\u00e7\u00f5es que constam na literatura m\u00e9dica como poss\u00edveis desencadeastes de piora dos sintomas no paciente miast\u00eanico. Muitas outras medica\u00e7\u00f5es podem interferir na doen\u00e7a, devendo-se sempre consultar um m\u00e9dico para o correto julgamento dos riscos e benef\u00edcios.<\/span><\/p>\n

 <\/p>\n

Refer\u00eancias<\/span><\/strong><\/p>\n

1. PASCUZZI, R.M.. Medications and Myastenia Gravis<\/strong>. Myastenia Gravis Foundation of America. 2007.<\/span>
\n2. DAROFF, R.B.. Disorders of Neuromuscular Trasmission<\/strong>. Bradley\u2019s Neurology in Clinical Practice. 7ed.<\/span>
\n3. Contraindication of drus that can make myastenia worse<\/strong>. Myaware \u2013 Fighting Myastenia Together. Dispon\u00edvel em <https:\/\/www.myaware.org\/information-for-medical-professionals\/39-xii-contraindications-of-drugs-that-can-make-myasthenia-worse>. Acesso em 18 de outubro de 2017.<\/span>
\n4. WITTBRODT, E.T.. Drugs and Myastenia Gravis<\/strong>. Archives of Internal Medicine. Vol 157. 1997.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

A miastenia gravis \u00e9 uma doen\u00e7a autoimune caracterizada pelo ataque aos receptores de acetilcolina nos m\u00fasculos. Este receptor \u00e9 respons\u00e1vel pelo in\u00edcio da contra\u00e7\u00e3o muscular, sendo assim o paciente com a doen\u00e7a desenvolve uma redu\u00e7\u00e3o importante na for\u00e7a muscular. Sabe-se que diversos medicamentos podem influenciar a contra\u00e7\u00e3o muscular, sendo por reduzir diretamente a for\u00e7a e<\/p>\n

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