Myasthenia syndrome of Eaton-Lambert

Cardiovascular -  palpitations, tachycardia, atrial fibrilation, hypotension

CNS -  paresthesia of lips, face and hands, feet, cold sensation in hands and feet.
            nervousness, lightheadedness,  jitteriness, increased irritability, tremor,
            trembling sensation, ataxia

Dermatologic-  Rash, flushing of pink complexion, folliculitis, petechiae,  pupura,
                          ecchymoses, sweating, skin eruption, dryness, and scaling of the skin

GI -           dry mouth, gastric irritation, anorexia, nausea, diarrhea, abdominal cramping,
                 gastro-intestinal side effects may  preclude the use of guanithidine as a desired
                 form of therapy

Hepatic- abnormal liver function tests.

Psychiatric -  emotional lability, psychotic state, confusion,  mood changes and hallucination,
                      acute interstitial nephritis

Miscellaneous- sore throat, fever

Guanithidine is contraindicated in individuals with a history of intolreanace or allergy to drug

Special Precautions-

Bone marrow suppression - fatal bone marrow suppression , apparently dose related can
occur with guanithidine

Lactation- patients on this drug should discontinue breast feedin

Children- safety and efficacy of the drug not evaluated in children

Monitoring- base line studies should be followed by frequent red and white cell and differential
counts. The drug should be discontinued upon appearance of bone marrow suppression

Concurrent therapy with drugs that may cause bone marrow suppression must be avoided

Renal function affected in some patients. Patients should therefore have their urine examinations
and serum creatinine determinations while taking the drug.

Indication-
Myasthenia syndrome of Eaton-Lambert

Dosage-
Initial dosage is between 10 and 15mg/kg  of body weight per day in 3 or 4 divided doses.
The dosage may be gradually increased to a total daily dosage of 35mg/kg of body weight
upto the development of side efects.

Individual tolerance is variable and once a tolerable dose is established it should be continued

Monitoring- base line studies should be followed by frequent red and white cell and differential
counts. The drug should be discontinued upon appearance of bone marrow suppression

Concurrent therapy with drugs that may cause bone marrow suppression must be avoided

Renal function affected in some patients. Patients should therefore have their urine examinations
and serum creatinine determinations while taking the drug.

Lactation-
Patients on this drug should discontinue breast feedin

Children-
Safety and efficacy of the drug not evaluated in children