Management of MS Flashcards Preview

Neurology > Management of MS > Flashcards

Flashcards in Management of MS Deck (15)
Loading flashcards...
1
Q

How is an acute exacerbation of MS managed

A

Mild-symptoms treatment
Moderate- oral steroids
Severe- admit/IV steroids

2
Q

How can pyramidal dysfunction be managed in MS ie weakness and spasticity

A
Physio
OT
Muscle relaxants
Nerve blocks
Surgery
3
Q

What skeletal muscle relaxants are used in MS

A

Oral Baclofen or tizanidine
IM botulinum toxin
Intrathecal baclofen/phenol
Intrathecal =injection into subarachnoid space of spinal canal

4
Q

How can sensory symptoms be managed

A
Anticonvulsant eg gabapentin
TCAD eg amitriptyline
Tens machine
acupuncture
lignocaine infusion
5
Q

How are urinary symptoms managed

A

Bladder drill
Anti cholinergics eg oxybutynin
Desmopressin
Catheter

6
Q

What are the first line disease modify ing therapies

A

Interferon Beta- Avonex, Rebif, Betaseron, Extavia
Glitiramer Acetate (Copaxone
Tecfedira

7
Q

What are second line disease modifying therapy

A

Tysabri

Fingolimod

8
Q

What is third line

A

mitoxantrone

9
Q

Describe the modes of each agent and how effective it is for the first line agents?

A

Interferon B and copazone = injection(SC or IM)
Decrease relapse rate by 1/3
Decrease severity of disability by 50 percent
Tecfedira= oral
50 percent reduction in relapse rate
good for RR ms

10
Q

When are second line treatments such as tysabri indicated

A

Highly active RRMS ie

  • rapidly evolving severe RRMS
  • high disease activity despite active interferon treatment or copaxone
11
Q

what is associated with tysabri

A

PML = progressive multi focal leukoencephalopathy
It is a rare and usually fatal viral disease characterized by progressive damage or inflammation of the white matter of the brain at multiple locations

12
Q

what causes PML

A

JC virus

13
Q

What is the risk of developing PML with tysabri

A

1/385 after two years

14
Q

When is mitoxanthron indicated

A

relapsing progressive MS

15
Q

How is mitoxantrone given and what are its down sides

A
12 infusions over 2 years
Cardiac toxicity (dose related)