Therapeutics for multiple sclerosis

Question 1

describe how spasticity can be managed

Answer 1

1. baclofen- GABA agonist
2. tizanidine- a2 adrenergic agonist
3. diazepam- positive allosteric modulator GABA receptor
4. dantrolene- antagonises ryanodine receptors
   - inhibiting ca2+ ion release from sarcoplasmic reticulum

Question 2

describe how optic neuritis can be managed

Answer 2

methylprednisolone

- synthetic glucocorticoid (oral steroid)

Question 3

describe how fatigue can be managed

Answer 3

amantadine

Question 4

describe how sexual dysfunction can be managed

Answer 4

sildenafil

- inhibits cGMP specific phosphodiesterase type 5

Question 5

describe the future treatment of laquinimod

Answer 5

1. experimental immunomodulator for treating MS
2. successor to the failed immunomodulator linomide
3. phase III trials thought to have failed, no significant reduction in RRMS relapses
   - however results later showed once daily administration slowed progression of disability and reduced rate of relapse RRMS

Question 6

describe the use of AHSCT in future treatments

Answer 6

1. extract stem cells from bone marrow
2. stem cells reintroduced into bloodstream
3. in some people, treatment has reduced relapses and improved disability

Question 7

describe the use of MD1003 in future treatments

Answer 7

1. highly concentrated form of biotin, a vitamin that activates some enzymes involved in cell growth and myelin production
2. taken orally 3x a day
3. currently in phase III trials