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Search the Internet for drugs being used or researched in the management of amyotrophic sclerosis, Huntington’s cholrea, and multiple sclerosis.
Provide a little detail about the drugs you find.
Wednesday, June 20, 2007
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Amyotrophic lateral sclerosis:
The drug riluzole (Rilutek) is the first and only medication approved by the Food and Drug Administration for slowing ALS. The drug appears to slow the disease's progression and prolong life by a few months in some people, perhaps by reducing glutamate levels. Your doctor may also prescribe medications to provide relief from muscle cramps and constipation and to reduce fatigue, excessive salivation and excessive phlegm. Some people with amyotrophic lateral sclerosis also benefit from medications for pain or depression. http://www.mayoclinic.com/health/amyotrophic-lateral-sclerosis/DS00359/DSECTION=7
Thalidomide for the Treatment of ALS is in a phase II study. Thalidomide is a sedative, hypnotic, and anti-inflammatory medication. http://clinicaltrials.gov/ct/show/NCT00140452;jsessionid=35D230F890DB83C187C2D72F9D984B9C?order=23 and www.wikipedia.org
Preclinical and clinical studies of gabapentin in patients with ALS led to undertake a phase III randomized clinical trial. Gabapentin (brand name: Neurontin) was initially synthesized to mimic the structure of GABA for the treatment of epilepsy. Presently, gabapentin is widely used as a medication to relieve pain, especially neuropathic pain. Gabapentin is well tolerated in most patients, has a relatively mild side-effect profile, and passes through the body unmetabolized. Gabapentin is similar in structure to the neurotransmitter GABA but is not believed to act on the same brain receptors. http://www.neurology.org/cgi/content/abstract/56/7/843 and www.wikipedia.org
Avicena Group, Inc. ("Avicena"), a developer of novel pharmaceutical and therapeutic products, announced today that a Phase II clinical trial of two combination therapies incorporating ALS-08, one of its proprietary drug candidates for the treatment of amyotrophic lateral sclerosis (ALS or Lou Gehrig's Disease) has been initiated. Investigators will assess the efficacy, as well as the safety and tolerability, of ALS-08 in separate combinations with celecoxib (a COX-2 inhibitor) and minocycline in patients with ALS. http://www.medicalnewstoday.com/medicalnews.php?newsid=46674
Huntington's Chorea:
Dopamine receptor-blocking agents (eg, phenothiazines, haloperidol) may be helpful in reducing some of the involuntary movements, but such therapy always should be coordinated with the primary care provider. http://www.emedicine.com/emerg/topic254.htm
Three classes of medication are commonly used to suppress chorea in Huntington's disease: neuroleptics, such as haloperidol and fluphenazine; benzodiazepines, such as clonazepam and diazepam; and dopamine depleting agents, such as reserpine and tetrabenazine. Each class has its advantages and disadvantages. http://endoflifecare.tripod.com/huntdiseasefaqs/id46.html
haloperidol: is a conventional, or typical, butyrophenone antipsychotic drug with pharmacological effects similiar to the phenothiazines.It is used in the treatment of schizophrenia and, more acutely, in the treatment of acute psychotic states and delirium.
Fluphenazine: is a typical antipsychotic drug used for the treatment of psychoses such as schizophrenia and acute manic phases of bipolar depression. It belongs to the piperazine class of phenothiazines and is extremely potent; more potent than haloperidol and around fifty to seventy times the potency of chlorpromazine.
Benzodiazepines: are a class of psychoactive drugs considered as minor tranquilizers with varying hypnotic, sedative, anxiolytic, anticonvulsant, muscle relaxant and amnesic properties, which are brought on by slowing down the central nervous system. This makes benzodiazepines useful in treating anxiety, insomnia, agitation, seizures, and muscle spasms, as well as alcohol withdrawal.
Clonazepam: is a drug which is a benzodiazepine derivative. It is a highly potent anticonvulsant, amnestic, and anxiolytic.
Diazepam: is a drug which is a benzodiazepine derivative. It possesses anxiolytic, anticonvulsant, sedative, skeletal muscle relaxant and amnestic properties. This makes it a useful drug for treating anxiety, insomnia, seizures, alcohol withdrawal, and muscle spasms.
Reserpine: is an indole alkaloid antipsychotic and antihypertensive drug known to irreversibly bind to storage vesicles of neurotransmitters such as dopamine, norepinephrine, and serotonin.
Tetrabenazine: is a drug for the symptomatical treatment of hyperkinetic movement disorder and is marketed under the trade names Nitoman® in Canada and Xenazine® in New Zealand and some parts of Europe, and is also available in the USA as an orphan drug.
www.wikipedia.org
Multiple Sclerosis:
There is no magic pill that cures MS or relieves all of its symptoms; but there are different medications and therapies, which lessen many symptoms, shorten attacks, and may slow down the expected slow and ongoing progression of Multiple Sclerosis.
Mitoxantrone (Novantrone) is an immunosuppressant, a type of medication that reduces the activity of the immune system. It has been used to treat leukemia and some advanced prostate cancer. Since multiple sclerosis (MS) appears to be a disease in which the immune system attacks the covering of the nerves (myelin sheath) within the brain and spinal cord, immunosuppressants may slow the progression of the disease. Immunosuppressants other than mitoxantrone, however, have not been shown to significantly reduce the progression of MS or the frequency of relapses. http://www.questdiagnostics.com/kbase/topic/detail/drug/tf4627/detail.htm
Tysabri is approved to treat patients with relapsing forms of multiple sclerosis (MS) to reduce the frequency of exacerbations. It was approved based on results achieved after approximately one year of treatment in ongoing controlled trials. Tysabri is a monoclonal antibody that binds to a protein called alpha-4-integrin. Integrins are found primarily on the surface of white blood cells, and play a role in immune system activity. http://www.weitzlux.com/tysabri/multiplesclerosismedicationavonexpml_609.html#1
Beta interferons: Interferon beta-1b (Betaseron) and interferon beta-1a (Avonex, Rebif) are genetically engineered copies of proteins that occur naturally in your body. They help fight viral infection and regulate your immune system.
Glatiramer (Copaxone): This medication is an alternative to beta interferons if you have relapsing remitting MS. Glatiramer is as effective as beta interferons in curbing MS attacks but shouldn't be used simultaneously. Doctors believe that glatiramer works by blocking your immune system's attack on myelin.
Corticosteroids: Doctors most often prescribe oral or intravenous corticosteroids to reduce inflammation in nerve tissue and shorten the duration of flare-ups. Prolonged use of these medications, however, may cause side effects such as osteoporosis and high blood pressure (hypertension).
Muscle relaxants: Tizanidine (Zanaflex) and baclofen (Lioresal) are oral treatments for muscle spasticity. If you have MS, you may experience muscle stiffening or spasms, particularly in your legs, which can be painful and uncontrollable. Baclofen often increases weakness in the legs while tizanidine appears to control muscle spasms without leaving your legs feeling weak, but it can be associated with drowsiness or dry mouth.
Medications to reduce fatigue: These may include antidepressants such as fluoxetine (Prozac), the antiviral drug amantadine (Symmetrel) or modafinil (Provigil), a medication for narcolepsy. All appear to work because of their stimulant properties.
http://www.mayoclinic.org/specialty-pharmacy/multiple-sclerosis.html
Amyotrophic Sclerosis:
-Galbapentin- (Neurontin) is an anticonvulsant medication indicated in the treatment of epilepsy and neuropathic pain. It is also used in the treatment of bipolar disorder
-Riluzole- it prolongs survival time but does not improve muscular strength or neurologic function
-Neurontin- is an anticonvulsant
-Rilutek- It inhibits glutamate release, and prolongs life approximately three months.
http://stason.org/TULARC/health/virtual-drugstore/als/index.html
Huntington’s cholrea
-tetrabenazine- is currently being reviewed by the U.S. Food and Drug Administration. If approved, the medication would be the first authorized by the agency for the treatment of Huntington's disease, which affects about 30,000 people in the United States.
-Haldol- suppress chorea
http://www.medicalnewstoday.com/medicalnews.php?newsid=37745
MS:
-Avonex- many patients report no perceived improvement, along with serious side-effects that substantially reduce quality of life
-Betaseron- works 2 % better than placebo
- Copaxone- GA is a synthetic random copolymer of the four amino acids
- Rebif- Interferon beta-1a is a drug in the interferon family
http://www.themcfox.com/multiple-sclerosis/ms-drugs/index.html
Amyotrophic lateral sclerosis:
The FDA has one approved drug for the treatment of ALS. The drug is riluzole (Rilutek), it is believed to reduce the damage to motor neurons by decreasing the release of glutamate. Studies have shown that patients have had prolonged survival by several months. The research has also shown that the patients are able to avoid being on a respirator longer. Other treatments such as physical, occupational, and speech therapist along with home and hospice care work along witht he individualized plan of medical therapy to keep the patient mobile and comfortable for as long as possible.
Research is being done to better understand the mechanism that causes ALS. The study includes SOD1 identification in animals, which leads to destruction of the motor neurons. Researchers are also conduction investigations to increase their understanding of the role of programmed cell death.
There are three classes of medications that are commonly used to suppress the chorea in Huntington's disease.
Neuroleptics- haloperidol, flupheazine
Benzodiazepines- clonazepam, diazepam
Dopamine depleting agents- reseprine, tetrabenazine
In most patients chorea eventually peaks and then begins to decline while rigidity and bradykinesia become more significant. It is at this point when drugs are need to help suppress the chorea.
Muliple Sclerosis
Effexor is used to treat depression and generalized anxiety disorder. It helps patients deal with the stress of their disease it eases the suffering for people who suffer from long-term depression.
Levitra is used to treat the erectile dysfunction that is party of the disease. It allows the males who have the disease the ability to recieve and maintain an erection. It is a vasodilator that allows the nitro oxide to fill the penis.
Nitrofurantoin is an antibiotic that prevents urinary tract infections, the drug works by damaging bacterial DNA making it a less reactive form. That is made possible by the rapid reduction of nitrofurantoin inside the bacterial cell flavoprotein.
Mitoxantrone is an anthracycline antineoplastic agent used in the treatment of cancer but is also used in fighting MS most notable seconday progression. Mitoxantrone is a type II topoisomoerase inhibitor which disrupts the DNA synthesis and DNA repair in both healthy cell along with cancer cells.
http://www.ninds.nih.gov/disorders/amyotrophiclateralsclerosis/detail_amyotrophiclateralsclerosis.htm#91824842
http://endoflifecare.tripod.com/huntdiseasefaqs/id46.html
http://en.wikipedia.org/wiki/Novantrone
http://en.wikipedia.org/wiki/Macrodantin
http://en.wikipedia.org/wiki/Levitra
http://en.wikipedia.org/wiki/Effexor
ALS
Riluzole (Rilutek) -- Only current disease-specific medication approved by US Food and Drug Administration for use in patients with ALS.
Baclofen (Lioresal) -- Treats spastic muscles. May induce hyperpolarization of afferent terminals and inhibit both monosynaptic and polysynaptic reflexes at the spinal level.
Tizanidine (Zanaflex) -- Treats spastic muscles. Centrally acting muscle relaxant. Possesses alpha2-adrenergic agonist properties. Metabolized in liver and excreted in urine and feces.
Pyridostigmine (Mestinon, Regonol) -- Acts in smooth muscle, CNS, and secretory glands, where it blocks action of acetylcholine at parasympathetic sites and facilitates transmission of impulses across myoneural junction.
http://www.emedicine.com/emerg/topic24.htm
HC
Haloperidol (Haldol) -- Useful in the treatment of irregular spasmodic movements of the limbs or facial muscles. Depression is common and may require treatment. Serotonin reuptake inhibitors or cyclic antidepressants may be tried. Irritability and explosive behavior are problems in some patients. Carbamazepine or valproate may be useful. Tranquilizers such as clonazepam (Klonopin) and antipsychotic drugs such as haloperidol (Haldol) and clozapine (Clozaril) can help control movements, violent outbursts and hallucinations. While these medications can be helpful, a common side effect is sedation, and in some cases, these medications may cause additional stiffness and rigidity. Various medications, including fluoxetine (Prozac, Sarafem), sertraline (Zoloft) and nortriptyline (Aventyl, Pamelor), can help control depression and the obsessive-compulsive rituals that some people with Huntington's disease develop. Medications such as lithium (Eskalith, Lithobid) can help control extreme emotions and mood swings.
http://www.mayoclinic.com/health/huntingtons-disease/DS00401/DSECTION=8
Beta interferons. Interferon beta-1b Beta-1b (Betaseron) and interferon beta-1a (Avonex, Rebif) are genetically engineered copies of proteins that occur naturally in your body. They help fight viral infection and regulate your immune system. The Food and Drug Administration (FDA) has approved beta interferons only for people with relapsing forms of MS who can still walk. Beta interferons don't reverse damage and haven't been proved to significantly alter long-term development of permanent disability. Some people develop antibodies to beta interferons, which may make them less effective. Other people can't tolerate the side effects, which may include symptoms similar to those of the flu (influenza).
Glatiramer (Copaxone). This medication is an alternative to beta interferons if you have relapsing remitting MS. Doctors believe that glatiramer works by blocking your immune system's attack on myelin. You must inject glatiramer subcutaneously once daily. Side effects may include flushing and shortness of breath after injection.
Natalizumab (Tysabri). This drug is administered intravenously once a month. It works by blocking the attachment of immune cells to brain blood vessels — a necessary step for immune cells to cross into the brain — thus reducing the immune cells' inflammatory action on brain nerve cells.
Mitoxantrone (Novantrone) is a chemotherapy drug used for many cancers. This drug is also FDA-approved for treatment of aggressive forms of relapsing remitting MS, as well as certain forms of progressive MS. It's given intravenously, typically every three months.
Corticosteroids. Doctors most often prescribe short courses of oral or intravenous corticosteroids to reduce inflammation in nerve tissue and to shorten the duration of flare-ups.
Muscle relaxants. Baclofen (Lioresal) and tizanidine (Zanaflex) are oral treatments for muscle spasticity. If you have multiple sclerosis, you may experience muscle stiffening or spasms, particularly in your legs, which can be painful and uncontrollable. This typically occurs in people with persisting or progressive weakness of their legs. Baclofen may temporarily increase weakness in your legs. Tizanidine controls muscle spasms without causing your legs to feel weak, but can be associated with drowsiness or a dry mouth.
Medications to reduce fatigue. To help combat fatigue, your doctor may prescribe an antidepressant medication, the antiviral drug amantadine (Symmetrel) or a medication for narcolepsy called modafinil (Provigil). All drugs prescribed for this purpose appear to work because of their stimulant properties. One study has showed that aspirin treatment may be effective in controlling MS-related fatigue; further research is planned to address the benefits of aspirin on fatigue.
http://www.mayoclinic.com/health/multiple-sclerosis/DS00188/DSECTION=7
ALS is treated with a drug called riluzole (Rilutek). It is the only drug used to treat ALS. Rilutek can reduce motor neuron damage by decreasing the release of glutamate. In studies, Rilutek prolonged the life of patients by several months. It doesn’t reverse the damage that has already been done to the motor neurons.
http://www.ninds.nih.gov/disorders/amyotrophiclateralsclerosis/detail_amyotrophiclateralsclerosis.htm
The Mitsubishu Pharma Corporation is undergoing studies to test the use of Edaravone (Radicut) in ALS patients. This drug is currently in phase III trials.
http://clinicaltrials.gov/ct/show/NCT00330681?order=11
The National Institute of Neurological Disorders and Stroke (NINDS) is currently in phase III with a drug called ceftriaxone hoped to be used in the treatment of ALS.
http://clinicaltrials.gov/ct/show/NCT00349622?order=16
Currently a drug called Haloperidol (Haldol) is used to help treat some the symptoms of Huntington's Chorea. It helps treat “irregular spasmodic movements of the limbs and facial muscles”. The adult dose is 2.5-10 mg/d PO divided bid/tid, and the pediatric dose is 0.5 mg/kg/d PO divided bid/tid. It’s also classified as a pregnancy type D drug.
http://www.emedicine.com/emerg/topic254.htm
The Huntington Study Group is in Phase II with a drug called Dimebon. They are studying the safety and tolerability of Dimebon in patients with short-term exposure.
http://clinicaltrials.gov/ct/show/NCT00387270?order=1
There are many medications used to treat the symptoms of MS. Amantadine is used for fatigue, Meclizine is used for nausea, vomiting and dizziness, Hydroxyzine is used for paroxysmal itching, interferon beat-1b is used as a disease-modifying agent, glatiramer acetate is also a disease-modifying agent, and diazepam is used for muscle spasms.
http://www.nationalmssociety.org/site/PageServer?pagename=HOM_LIVE_medications_used_in_ms
Novantrone was the first secondary-progressive drug approved by the FDA. It was approved on October 13, 2000. It’s used to “reduce neurologic disability and/or the frequency of clinical relapses in patients with secondary-progressive MS”.
http://www.nationalmssociety.org/site/PageServer?pagename=HOM_LIB_sourcebook_chemotherapy
Currently the Artielle Immuno Therapeutics is in Phase I with RTL1000 (recombinant T cell receptor ligand). This drug is hoped to “specifically control the abnormal immune response or attack against the insulation on the nerves that occurs in multiple sclerosis”.
http://clinicaltrials.gov/ct/show/NCT00411723?order=2
amyotrophic sclerosis
Riluzole (Rilutek)-decreases the release of glutamine and reduces damage to motor nerons. May cause liver damage.
RNAi dug name (Arimclomol)-shuts down specific genes that lead to ALS
http://en.wikipedia.org/wiki/Amyotrophic_Lateral_Sclerosis#Diagnosis
Baclofen or diazepam are used to control spasticity that interferes with daily living
http://www.nlm.nih.gov/medlineplus/ency/article/000688.htm#Treatment
Huntington’s cholrea (now known as huntington's disease)
Treatments are avaliable to treat the emotional symptoms such as antidepressants and antipsychotics.
Dopaminergic antagonists bind to receptors and block various effects.
www.wikipedia.org/chorea
Multiple Sclerosis:
Interferons-regulate the immune system. Betaseron, Avonex, Rebif, and Betaseron are some examples.
Glatiamer Acetate-Copaxone this drug stimulates T cellsand changes them from harmful agents to benficial agents that reduce nflammation.
Mitoxatrone-Novantrone- this drug is used in worsening patients.
Natalizumab-tysabri- is used with mmunotherapies.
ww.wikipedia.orgwiki/multile_sclerosis
Amyotrophic Sclerosis:
Riluzole (Rilutek) Aventis Pharmaceuticals: is believed to decrease glutamate release and delays the onset of ventilator-dependence or tracheostomy in selected patients and block TTX-S sodium channels and may increase survival by approximately two months.
Mecasermin (Increlex) (still under FDA review): An insulin-like growth factor 1 (IGF-1) that helps in the growth of bones and muscle.
Drugs that help spasticity include baclofen (Lioresal) 10-25mg tid, diazepam (Valium)2-15mg tid, dantrolene (Dantrium) 50-100mg 4 times a day, Nonsteroidal anti-inflammatory agents and anticonvulsive medications include carbamazepine (Tegretol) 200mg tid, and phenytoin (Dilantin) 300mg at bedtime
http://www.drugs.com/mtm/mecasermin.html
http://en.wikipedia.org/wiki/Riluzole
http://www.aafp.org/afp/990315ap/1489.html
Huntington’s Cholrea:
Haloperidol (Haldol) Janssen Pharmaceutica: an antipsychotic drug used in the treatment of schizophrenia and delirium.
Benzodiazepines including Diazepam (Valium) and derivatives: "possesses anxiolytic, anticonvulsant, sedative, skeletal muscle relaxant and amnestic properties." ~Wikipedia
Multiple Sclerosis:
Avonex: treats relapsing forms of MS. recombinant DNA produced synthetic of naturally occurring proteins. given via im injection once a week.
Betaseron: recombinant DNA produced synthetic of naturally occurring proteins. Given via subcutaneous injection every other day.
Betaferon: recombinant DNA produced synthetic of naturally occurring proteins. Given via subcutaneous injection every other day.
Copaxone: synthetically produced facsimile of four naturally occurring amino acids: L-glutamic acid, L-alanine, L-tyrosine and L-lysine. Given via subcutaneous injection.
Rebif: recombinant DNA produced synthetic of naturally occurring proteins. Given via subcutaneous injection three times a week.
http://www.themcfox.com/multiple-sclerosis/ms-drugs/multiple-sclerosis-drugs.htm
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