رجل عمره ٥٨ سنة عنده وهن عضلي وبيل، يأخذ بيريدوستيغمين ٣ مرات يومياً في أوقات عشوائية. يقول إنه يتعب في المضغ ويجد صعوبة في البلع أثناء الأكل، خاصة في آخر الوجبة. ما أفضل توقيت للدواء؟

A 58-year-old man with myasthenia gravis takes pyridostigmine three times a day at random times. He tires chewing and has difficulty swallowing during meals, especially towards the end. When is the best time to take the drug?

1. Once only at bedtime
2. Three hours after meals
3. About 30–60 minutes before meals
4. Only with the evening meal

Answer: C) About 30–60 minutes before meals. Taking pyridostigmine 30–60 minutes before eating times its peak effect for meals, improving chewing and swallowing. Doses are taken at fixed times.