Amyotrophic lateral sclerosis (ALS/Lou Gehrig disease)

Question 1

Drugs used for ALS - 3 drugs

Answer 1

Baclofen
Gabapentin
Riluzole

Question 2

Baclofen - MOA

Answer 2

Activate GABAb receptor and reduce motor neuron excitability

Question 3

Which drug is used to reduce spasticity in ALS and MS?

Answer 3

Baclofen

Question 4

Baclofen - adm

Answer 4

Oral, injectable, intrathecal infusion.

Question 5

Baclofen - adverse effects

Answer 5

Dizziness, fatigue, weakness

Question 6

Which drug may slow the loss of muscle strength in ALS?

Answer 6

Gabapentin

Question 7

Which drug may slow progression of disease and prolong life in ALS?

Answer 7

Riluzole

Question 8

Gabapentin - adverse effects

Answer 8

Ataxia, dizziness, drowsiness, nystagmus, tremor

Question 9

Gabapentin - interactions

Answer 9

Antacids decrease levels

Question 10

Riluzole - MOA

Answer 10

Protect motor neurons from the neurotoxic effects of excitatory amino acids, and prevent anoxia-related death of cortical neurons. Unclear mechanism, maybe inhibition of voltage-gated sodium channels that mediate glutamate release

Question 11

Riluzole - adverse effects

Answer 11

Asthenia, diarrhea, dizziness, drowsiness, increased hepatic enzyme levels, nausea, vomiting, paresthesias, vertigo

Question 12

Riluzole - interactions

Answer 12

Quinolones and theophylline can increase serum levels.

Omeprazole, rifampin and smoking can decrease serum levels.