Complications, such as infections, deep vein thrombosis, or respiratory insufficiency, should be managed appropriately. Refer patients to a neurologist experienced in the diagnosis and treatment of neuromuscular diseases. Refer to a pulmonologist if respiratory failure is imminent and patient wishes allow. These medications include cephalosporins, fluoroquinolones, vancomycin, penicillins, and aminoglycosides. Glutamate antagonists - Extends survival or time to tracheotomy.
Actions appear to be indirect.
May induce hyperpolarization of afferent terminals and inhibit both monosynaptic and polysynaptic reflexes at the spinal level. Centrally acting muscle relaxant. Possesses alpha2-adrenergic agonist properties. Metabolized in the liver and excreted in urine and feces. Cholinergic agents - For patients with ALS who may have secondarily impaired neuromuscular junction transmission.