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Multiple Sclerosis Therapy (Baclofen (MOA GABAB agonist Skeletal muscle…
Multiple Sclerosis Therapy
Methylpred
High dose (up to 1g/day) for acute flares.
Short course (3-5 days)
MOA
Inhibits PLA2 → ↓PG and ↓ PAF
↓PMN extravasation → ↑PMN in blood
Lymphopaenia
↓Phagocytosis
↓ Ab production
↓ cytokine and proteolytic enzyme
SE
Cushing’s
DM
Central obesity
Dyslipidaemia
PUD
Osteoporosis
Hirsutism, acne
Interferon-β1
SE
Flu-like symptoms
Injection site reaction
CI
Decompensated L
Severe depression
Used for Relapsing remitting or
secondary progressive MS
Monitor for hepatotoxicity
Glatiramer
MOA
Random polymer of amino acids found
in myelin basic protein
? acts as decoy
SE
Flu-like symptoms
Injection site reaction
Use Relapsing remitting MS
Natalizumab anti-α4 integrin
Alemtuzumab anti-CD52
Baclofen
MOA GABAB agonist
Skeletal muscle relaxant
SE
Sedation
↓ tone
Nausea
Urinary disturbance
CI PUD
fx ↑d by TCAs Rx painful muscle spasms
Don’t withdraw abruptly
hyperthermia
↑ spasticity
Dantrolene
CI in L
SE
Hepatotoxicity
GI upset
MOA
Prevents Ca2+ release from
sarcoplasmic reticulum
Skeletal muscle relaxant
Oxybutynin
Antimuscarinic
SE
Dry mouth
GI upset
Blurred vision
Used for detrusor instability
CI
Myasthenia
GI/bladder obstruction