MS treatment Flashcards
what are the type of beta interferons used for the treatment of MS ?
Avonex intramuscular
Rebif subcutaneous
Betaferon subcutaneous
what are the types of glatrimer acetate available for use in MS patients ?
copaxone subcutaneous injection
what are the three types of medications available for MS patients ?
glatiramer acetate
natalizumab (Tysabri)
Beta interferons
what are the guidlines for using beta interferons and glatiramer acetate in RRMS ?
2 relapses in 2 years.
able to walk without assistance
what are the guidlines for using beta interferons is SPMS ?
2 relapses in n2 years
able to walk a minimum of 10 m alone
minimal increase in disability over the last 2 years
what is the effect of beta interferon ?
reduces relapse rates
reduces severity of relapses
beat interferons have no effect on which disease progression course of MS ?
no effect on primary or secondary progression
what are the side effects of beta interferons ?
flu like symptoms hair loss depression thyroid disease injection site reaction
which disease course does glatiramer acetate have no effect on ?
no effect on primary progressive MS
what are the side effects of glatiramer acetate ?
injection site reaction
allergic reaction
lipoatrophy
are there any differences in relapse rates between glatiramer and b interferon ?
no differences
what is the first line treatment for rapidly evolving RRMS ?
natalizumab (Tysabri)
what are the guidelines for using natalizumab in RRMS ?
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
what is the second line treatment for RRMS with high disease activity ?
beta interferons
what are the guidlines for using beta interferons
in RRMS with high disease activity ?
1 relapse in the previous year while on therapy
and
at least 9 T2 lesions or one enhancing lesion
what is the main mechanism of action of natalizumab ?
binds to alpha-4 integrin on the immune cells
if we want to reduce the number of new MRI lesions which drug shold be used ?
Natalizumab
what are the side effects of Natalizumab ?
infections infusions urticaria headache dizziness PML
what symptomatic treatment can be used for the fatigue ?
modafinil
what symptomatic treatment can be used for the urinary symptoms ?
oxybutynin
when do we give oxybutynin ?
bladder scan revealing less than 100 ml
how do you approach a patient with PPMS ?
no evidence that DMT are that useful but we can give ocrelizumab but symptomatic treatment is the focus
what can be used to treat the symptoms of spasticity?
botox injections
what can be used for the treatment of paroxysmal symptoms ?
carbamazepine
