Which medication should the nurse have available for a client with myasthenia gravis exhibiting signs of cholinergic crisis?

The medication that should be available for a client with myasthenia gravis exhibiting signs of a cholinergic crisis is atropine sulfate. In the context of myasthenia gravis, a cholinergic crisis occurs due to an excess of acetylcholine, often as a result of too much acetylcholinesterase inhibitor medication. This leads to symptoms such as increased salivation, lacrimation, urination, diarrhea, gastrointestinal distress, and muscle twitching due to overstimulation of the neuromuscular junction.

Atropine sulfate is an anticholinergic agent that can effectively counteract the effects of too much acetylcholine by blocking acetylcholine receptors. This helps to alleviate the respiratory distress and excessive secretions associated with a cholinergic crisis.

Understanding the role of other medications can provide further clarity. Neostigmine and pyridostigmine are both acetylcholinesterase inhibitors used to treat myasthenia gravis, but in a cholinergic crisis, they would exacerbate the symptoms rather than alleviate them. Edrophonium is a short-acting acetylcholinesterase inhibitor that is often used for diagnostic purposes in myasthenia gravis and can also lead to increased