MS treatment

Question 1

what are the type of beta interferons used for the treatment of MS ?

Answer 1

Avonex intramuscular
Rebif subcutaneous
Betaferon subcutaneous

Question 2

what are the types of glatrimer acetate available for use in MS patients ?

Answer 2

copaxone subcutaneous injection

Question 3

what are the three types of medications available for MS patients ?

Answer 3

glatiramer acetate
natalizumab (Tysabri)
Beta interferons

Question 4

what are the guidlines for using beta interferons and glatiramer acetate in RRMS ?

Answer 4

2 relapses in 2 years.

able to walk without assistance

Question 5

what are the guidlines for using beta interferons is SPMS ?

Answer 5

2 relapses in n2 years
able to walk a minimum of 10 m alone
minimal increase in disability over the last 2 years

Question 6

what is the effect of beta interferon ?

Answer 6

reduces relapse rates

reduces severity of relapses

Question 7

beat interferons have no effect on which disease progression course of MS ?

Answer 7

no effect on primary or secondary progression

Question 8

what are the side effects of beta interferons ?

Answer 8

flu like symptoms 
hair loss 
depression 
thyroid disease 
injection site reaction

Question 9

which disease course does glatiramer acetate have no effect on ?

Answer 9

no effect on primary progressive MS

Question 10

what are the side effects of glatiramer acetate ?

Answer 10

injection site reaction
allergic reaction
lipoatrophy

Question 11

are there any differences in relapse rates between glatiramer and b interferon ?

Answer 11

no differences

Question 12

what is the first line treatment for rapidly evolving RRMS ?

Answer 12

natalizumab (Tysabri)

Question 13

what are the guidelines for using natalizumab in RRMS ?

Answer 13

2 or more disabling relapses in one year

one or more enhancing lesions or a significant increase in T2 lesions in comparison with previous MRIs

Question 14

what is the second line treatment for RRMS with high disease activity ?

Answer 14

beta interferons

Question 15

what are the guidlines for using beta interferons

in RRMS with high disease activity ?

Answer 15

1 relapse in the previous year while on therapy
and
at least 9 T2 lesions or one enhancing lesion

Question 16

what is the main mechanism of action of natalizumab ?

Answer 16

binds to alpha-4 integrin on the immune cells

Question 17

if we want to reduce the number of new MRI lesions which drug shold be used ?

Answer 17

Natalizumab

Question 18

what are the side effects of Natalizumab ?

Answer 18

infections 
infusions 
urticaria 
headache 
dizziness 
PML

Question 19

what symptomatic treatment can be used for the fatigue ?

Answer 19

modafinil

Question 20

what symptomatic treatment can be used for the urinary symptoms ?

Answer 20

oxybutynin

Question 21

when do we give oxybutynin ?

Answer 21

bladder scan revealing less than 100 ml

Question 22

how do you approach a patient with PPMS ?

Answer 22

no evidence that DMT are that useful but we can give ocrelizumab but symptomatic treatment is the focus

Question 23

what can be used to treat the symptoms of spasticity?

Answer 23

botox injections

Question 24

what can be used for the treatment of paroxysmal symptoms ?

Answer 24

carbamazepine