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A child with myasthenia gravis complains of difficulty with chewing and facial movements. The physician orders neostigmine to improve muscle tone. What time should the patient take this medication to improve muscle tone while chewing?

Explanation

•Neostigmine has a half life of only 50 minutes, so it should be taken about 30 minutes before meals to improve tone of the muscles of mastication.

•Neostigmine is an acetylcholinesterase inhibitor. It prevents the breakdown of acetylcholine to increase activitation of nicotinic and muscarinic receptors, leading to muscle contraction.

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