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Drugs for MS, ALS, & Alzhiemer's by Mind Map: Drugs for MS, ALS, &
Alzhiemer
0.0 stars - reviews range from 0 to 5

Drugs for MS, ALS, & Alzhiemer's

MS

Interferons

Interferone beta-1b, Betaseron, Extavia

Interferon beta-1a, Avonex, Rebif

MOA, Immunomodulatory actions, Decreases Ag presentation in the CNS, Limits immune attack on myelin

PK, Major difference btwn the two interferon types is kinetic, All are proteins, so much be given via injection, B & R are given alternate days SQ injection, Avonex is weekly IM injection

SE, Flu-like Sx, Ab formation (can limit drug effectiveness, Depression

Glatiramer

MOA, Synthetic compound that resembles a component of myelin, Protects myelin by acting as a "decoy," attracting immune cells away from myelin

Use, Relapsing-remitting MS, Decreases rate of relapse

Admin, Given SQ, QID

SE, Generally well tolerated, Flushing, chest tightness, SOB, Feels like an MI, but it's not!, Joint and muscle pain/stiffness

Mitoxantrone

MOA, chemotherapeutic agent, suppresses immune attack on myelin

SE, N, bladder infxn, mouth sores, amenorrhea, Cumulative effect on cardiac conduction, Only use for 2-3 years

Natalizumab

MOA, Recombinant MAB, Binds adhesion molecule on activated lympho- and monocytes, Blocks adhesion and prevents leukocyte entry into CNS, Decreases immune attack on myelin

SE, Minor, Headache, fatigue, Allergic rxns and Ab formation, The Big Bad one: progressive multifocal leukoencephalopathy (PML), Caused by JC virus

Fingolimod

MOA, Inhibits migration of T cells out of lymph nodes

Use, Prevents relapse and progression of Sx

PK, Slow but complete absorption, Long 1/2 life (4-9 days), Highly protein bound, 1st oral specific Tx

SE, Bradycardia, Increased infxns

Symptomatic Tx of MS

Anti-inflammatory steroids

Methylprednisolone, dexamethasone, prednisone, betamethasone, prednisolone

MOA, Close damaged BBB, Reduce inflammation in the CNS

Anti-depressants

Both SSRIs and tricyclics

Use, Depression associated w/ MS

Amitriptyline, Carbamazepine, & phenytoin

Tx for neuralgia

Imipramine

Use, Urinary incontinence

MOA, Strong antimuscarinic effect

Anti-spasmodics (diazepam, clonazepam, dantrolene, etc)

Amantadine - tremors/fatigue

Meclizine - vertigo

Oxybutanin - urinary incontinence

Amyotrophic Lateral Sclerosis (ALS)

Riluzole

The only drug apprvoed for specific Tx of ALS

MOA, Voltage-gated Na-channel blocker, Inhibits glutamate release, Slows progression of Dz

PK, Highly plasma bound

SE, asthenia, dizziness, vertigo, NVD, Circumoral perathesias, SGPT elevation, Monitor liver chemistry!, Tx-limiting

Non-specific Tx

Baclofen: Tx spacicity

Gabapentin: slows decline in M strength

Alzheimer's Dz

Specific Tx

Acetylcholinesterase inhibitors, Donepezil, Galantamine, Tacrine, Revistigmine, MOA, Pts w/ AD have decreased cholinergic activity in cortex and hippocampus, These increase it, But doesn't really work

Memantine, MOA, "use-dependent" NMDA receptor antagonist, Only kicks in as an antagonist at high levels of activity, blocks overstimulation of NMDA receptors (which are toxic to neurons) by glutamate, Allows low levels of receptor activation, Use, Slows progression of Dz, Often used as adjunct to cholinesterase inhibitors, May be used in other neurodegenerative Dzes (ALS, PD, epilepsy), AE, Generally well tolerated, Dizziness, headache, constipation, confusion

Non-specific Tx

SSRIs & atypical antipsychotics, Typical antipsychotics increases risk of stroke!

Gingko, Modest improvement in memory

Caprylidene, MOA, AD may be d/t impaired glucose metab. So we're giving them ketones instead, Experimental Tx, PK, "medical food" that is metabolized to ketones. Provide energy to brain