A 28-year-old female presents with fluctuating fatigue, drooping of her eyelids, difficulty swallowing, and slurred speech. The patient is given a drug that affects an enzyme's activity, and kinetic analysis of the enzyme-catalyzed reaction, in the presence and absence of the drug, is shown below. The effect of this medication can best be described by which set of terms below?

The patient has myasthenia gravis, and the treatment is pyridostigmine, a competitive, reversible inhibitor of acetylcholinesterase. Myasthenia gravis is caused by autoantibodies to the acetylcholine receptor, reducing the effectiveness of acetylcholine at the neuromuscular junction. By reversibly inhibiting acetylcholinesterase, the effective levels of acetylcholine are increased, thereby providing sufficient acetylcholine to bind to the few functional receptors that remain. The graph is classic for a competitive inhibitor. Competitive inhibitors display an increased apparent Km and a constant Vmax .