Mga medication list 12 1 12

MYASTHENIA GRAVIS MEDICATION LIST Key: 1 - Contraindicated. Avoid in MG patients, even if disease is controlled.

2 - Likely to worsen MG. Systemic administration should only be done in a hospital where ventilation support is available.

3 - May worsen MG. Usually is well tolerated but use with caution.

4 - Have caused problems in rare cases. Usually not a problem for the majority of MG patients.

5 - Have been shown to cause an autoimmune, temporary form of MG.

ANTIBIOTICS Class Ketolide Aminoglycosides

Polypeptides

Key Brand Name 1 Ketek, Ketek pak 2 Gentak, Garamycin, Nebcin, Amikin, Tobrex, Tobrasol 2 AK-Tracin, etc.

Generic Name Telithromycin

Comments

Gentamicin, Amikacin, Tobramycin, Neomycin, Streptomycin

Eye preparations may exacerbate ophthalmic myasthenia Safe as topicals

Bacitracin, Polymyxin, Colistin

1

ANTIBIOTICS (CONT’D) Class Glycopeptides Lincosamide Fluoroquinolones

Key 2 2 3

Brand Name Vancocin Cleocin Cipro, Levaquin, Gatiflo, Noroxin, Floxin, etc.

Ery-Tab, Zithromax, Biaxin, etc.

Minocin, Doryx, Oraxyl, etc.

Bactrim, Septra,etc.

Principen, Amoxil, Veetids, etc.

Generic Name Vancomycin Clindamycin Ciprofloxacin, Levofloxacin, Gatifloxacin, Norfloxacin, Ofloxacin, etc.

Imipenem Hydroxychloroquine, Quinine, Chloroquine etc.

Macrolides

3

Tetracyclines

3

Sulfonamides

4

Penicillins

4

Carbopenems Aminoquinolone, Cinchona Alkaloid

4 3

Primaxin Plaquenil, Qualaquin, Aralen, etc.

Anti-retroviral Other

3 3

Ritonavir Macrobid Flagyl

Comments Ear preparations generally considered safe

Erythromycin, Azithromycin, Clarithromycin, etc.

Minocycline, Doxycycline, Tetracycline, etc.

Sulfamethoxazole/Trimethoprim, etc.

Ampicillin, Amoxicillin, Penicillin VK, Penicillin G, etc.

Nitrofurantoin Metronidazole

2

Little evidence of any other penicillin causing problems.

These are antimalarials, but may be used for other indications.

CARDIOVASCULAR DRUGS Class Class 1 Antiarrhythmics

Key Brand Name 2 Procanbid, Quinaglute, Pronestyl, Xylocaine, etc.

Beta Blockers

3

Tenormin, Toprol, Lopressor, Inderal, Trandat, Normodyne, etc.

Calcium Channel Blockers

3

Isoptin, Norvasc, Calan, Plendil, Rendil, Adalat, Procardia, etc.

Statins

3

Lipitor, Zocor, etc.

Alpha Blockers

5

Aldomet

Other

2

Arfonad

Generic Name Procainamide, Quinidine, Lidocaine, etc.

Atenolol, Labetolol, Metoprolol, Sotalol, Propranolol, etc.

Verapamil, Amlodipine, Nicardipine, Felodipine, Nifedipine, etc.

Atorvastatin, Simvastatin,etc.

Alpha Methldopa Trimethaphan

Comments Avoid use if possible unless arrhythmia is an emergency and there’s no alternative.

Oral, parenteral and ophthalmic preparations

Verapamil is the worst drug in this class but all should be used with caution.

Additionally, diuretics may cause low potassium as a side effect, which could cause muscle weakness. Patients should have their potassium levels monitored regularly.

3

ANTI-EPILEPTICS (SEIZURE MEDICATIONS) Class Hydantoin

Key Brand Name 3 Dilantin, Cerebryx

Oxazolidinedione Barbiturates

5 4

Tridione Phenobarbitone, Pentobarbital, etc.

Succinimide Dibenzapine Carboxamide Other

4 4

Zarontin Tegretol, Carbatrol Neurontin

3

Generic Name Phenytoin, Fosphenytoin Trimethadione Phenobarbital, Pentobarbital, etc.

Ethosuximide Carbamazepine

Comments

Gabapentin

EYE DROPS Class Key Brand Name Carbonic Anhydrase 3 Diamox Inhibitor Local Anesthetic 3 Parcaine, etc.

Beta Blockers

3

Anticholinesterase

3

Generic Name Acetazolamide

Proparacaine, Bupivicaine, etc.

Betoptic, Tenopt, Betaxolol, etc.

Timolol, etc.

Phospholine Iodide Ecothiophate

4

Comments

PSYCHIATRIC MEDICATIONS Class Anti-manic Phenothiazine

Butyrophenones

Key Brand Name 3 Eskalith 3 Largactil, Thorazine, Prolixin, Compazine, Trilafon, etc.

3 Haldol, Inapsine, Orap

Benzodiazepines

4

Xanax, Valium, Ativan, etc.

Tricyclics

3

Elavil, Pamelor, Tofranil, etc.

Other

3

Dexedrine

Generic Name Comments Lithium Chlorpromazine, Also used as Fluphenazine, antiemetics Perphenazine, Prochlorperazine, Sparine, etc.

Haloperidol, Droperidol, Pimozide Alprazolam, Diazepam, Iorazepam, etc.

Amitriptyline, Nortriptyline, Imipramine Amphetamine

NEUROMUSCULAR BLOCKING MEDICATIONS Class Key Brand Name All Neuromuscular 2 Quelicin, Anectine, Blocking Drugs etc.

5

Generic Name Comments Succinylcholine, Only use if etc. ventilation, etc. is available.

Both polarizing and depolarizing classes are included.

ANESTHETICS Class Inhalation Anesthetics Local Anesthetics

Key Brand Name 2 Forane, etc.

3

Generic Name Isoflurane, etc.

Xylocaine, Novocaine, Sensorcaine, etc.

Comments

Cocaine, Lidocaine, Proparacaine, Bupivacaine, Procaine, etc.

Patients should always consult with their physician before surgery.

Patients should always tell their anesthesiologist about a MG diagnosis.

MISCELLANEOUS Class Musculoskeletal agent

Chemotherapeutic agents Immunological Agent Other neurological agents

Key Brand Name 2 Botox

2 5 4

Generic Name Comments Botulinum Should not be Toxin Type A used without discussion with neuromuscular specialist Cisplatin, Platin, Cisplatinum, Fludarabine Fludara Intron A, Interferon Interleukin Alpha Rilutek, Riluzole, Copaxone Glatiramer

6

MISCELLANEOUS (CONT’D) Class Antacids and Laxatives

Key Brand Name 3 Mylanta, Maalox, Citroma

Corticosteroids

3

Deltasone, Decadron, etc.

Antiarthritic

2

Cuprimine

Narcotics

3

Morphine, Demerol, Fentanyl, MS Contin, etc.

Generic Name Magnesium hydroxide, Magnesium citrate

Comments Only magnesium containing antacids or laxatives are a problem Prednisone, Can be used Dexamethasone, to treat etc. myasthenia D-penicillamine Should not be used without discussion with neuromuscular specialist Meperidine, If there is a Duragesic, etc. respiratory compromise

All drugs that are respiratory depressants or sedatives and hypnotics should be used with caution in patients with Myasthenia.

Hematologists/Oncologists should be aware of a MG diagnosis before chemotherapy is initiated.

This list is not comprehensive and these drugs may affect each person differently.

Please check with your neurologist before surgeries or adding medications.

Myasthenia Gravis Association 6400 Prospect Avenue-East, Suite 300A Kansas City MO 64132 816-256-4100 mgakc.org mgakc@sbcglobal.net 12-1-12 7