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  #1  
Old 02-21-2012
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Listening MUSK Protein & Worsen Drug

A 50 year old man present with muscle weekness that occurs after any type of exercise. Aneurologic examination reveals the muscle supplied by the cranal nerves are 1rily affected. If Lab test show no antibodies against nicotinic receptors but reveals antibodies against the MUSK protein, wich of the following is most likly to worsen the patien condition


A- Albuterol
B- Azathioprine
C- Fluoxetine
D- Gentamicin
E- Mycophenolate mofetil
F- Prednisone


Please,leave some reference for your explanation; because I not desire to repeat the same mistake this time in my exam.THANK YOU
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Old 02-21-2012
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what a Qs .........

well found out that Antibodies directed against this MUSK protein are found in those patients with myasthenia gravis not demonstrating antibodies to the acetylcholine receptor (sero-negative).The phenotype of these patients appears to be different from those of many other myasthenic patients: more likely women, less eye involvement, more likely to have weakness of neck and oropharynx, and more likely to be African-American in ethnicity.

thus any anticholinergic would affect it ..... so ans C ..... SSRI have a very few anticholinergic SE ....... but still they would affect this patient .....
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Is very difficult this question,but should you give me the source of your very util explanation
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Old 02-21-2012
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Gentamicin an aminoglycoside has neuromuscular blockade effect so should be avoided in this condition
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http://en.wikipedia.org/wiki/MuSK_protein
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Old 02-21-2012
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oops ..... Jinni is correct its gentamycin ....... neuromuscular blockade never struck me ......

http://dig.pharm.uic.edu/faq/myasthenia.aspx
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Old 02-22-2012
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So, what is the best answer in our case? for me was FLUOXETINE after reading FA but with this link the answer should be GENTAMYCIN.

Last edited by alfjof; 02-22-2012 at 08:34 AM.
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Old 02-22-2012
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This is my first time seeing thi MUSK protein.

So what you guys are saying is musk is like a precursor to the meuromuscular junction? And that antibodies to it can produce a kind of myasthenia? And gentamicin has neuromuscular blocking side effects so therefore should be avoded because it will worsen the myasthenia? And by that logic a neuromuscular reuptakr inhibitor will better the condition?
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Quote:
Originally Posted by khushi.chahal View Post
This is my first time seeing thi MUSK protein.

So what you guys are saying is musk is like a precursor to the meuromuscular junction? And that antibodies to it can produce a kind of myasthenia? And gentamicin has neuromuscular blocking side effects so therefore should be avoded because it will worsen the myasthenia? And by that logic a neuromuscular reuptakr inhibitor will better the condition?
In conclusion,you can read it in those links above to clear you about the question
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Quote:
Originally Posted by alfjof View Post
So, what is the best answer in our case? for me was FLUOXETINE after reading FA but with this link the answer should be GENTAMYCIN.
Its Gentamicin
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Quote:
Originally Posted by alfjof View Post
In conclusion,you can read it in those links above to clear you about the question
you're a great help. thank you.
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Listen I will post a lot of question I got then are helpful for us and I am confused about the answer
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