Introduction of immunomodulatory therapy has opened a whole range of symptomatic management: the treatment of side effects in Multiple Sclerosis. Both, glatiramer acetate and beta-interferon can produce skin reactions. These skin side effects are different and can vary if the Multiple Sclerosis patient continue to follow the treatment. In treatment with glatiramer acetate, hyperemia is frequently observed at initial site of injection, which is irritating but not in a degree too high.
Most times, this can be remedied by introducing drug deeper into the subcutaneous tissue. In time, even if the product is placed deep, redness tends to disappear, but almost inevitably lipodystrophy atrophy of subcutaneous tissue nodules and cavities can occur after several years of treatment. The skin itself becomes rough and tough, the patient is starting to have problems in finding a place to inject the medicine.
Approximately 10% of Multiple Sclerosis patients who are using glatiramer acetate can develop several reactions after the injection treatment such as dyspnoea, chest pain, sweating and fear of death. This severe reaction lasts about 20 minutes but can be extended for a few hours before they are spontaneously disappearing. It is important for all Multiple Sclerosis patients to be educated about this side effect in order to avoid requesting emergency services and associated expenses. Reassurance is the best treatment, even if sometimes seems to be very conservative.
Interferons (both beta-1a as well as beta-1b) can causes dramatic skin reactions, but by initiating therapy with lower doses and escalating further slow, these reactions can be minimized. Some patients with Multiple Sclerosis may have need a month to reach the maximum dose with good tolerability. Flu-like symptoms are common at the onset of treatment and also can be spared by slow titration of dosage. Although lipodystrophy occurs to interferon, it is much more rare than in the case with glatiramer acetate, which can be explained simply by the less number of necessary injections. Interferon-beta 1a intramuscular injection does not cause skin reactions, but flu-like symptoms can be exaggerated. It is required monitoring of blood count and liver function, with dose adjustment if it is necessary.
Administration of natalizumab in patients with multiple sclerosis can cause allergic reactions which will stop the treatment. Anaphylaxis can occur occasionally and can reduce normal immune defense which will lead to opportunistic infections. Mitoxantrone has been associated with heart failure and leukemia. Doctors will be monitoring these pathologies by ultrasound, blood tests and observation. Therefore, treatment of symptoms is an ordeal in every treatment available.
Conclusions
Generally, Multiple Sclerosis Treatment, philosophy is to determine each patient cope better as far as possible with any disability / symptom that he / she has. This means treating disease, disease symptoms and the patient who has the disease. This is a philosophy of action. However, it will take into account the maximum care "primum non nocere" (no damage). Sometimes doctors use aggressive combination of a lot of medications used to treat a myriad of symptoms. Patients with multiple sclerosis, otherwise like all other patients, desires to treat all their upsets and doctors prescribe them properly. Metabolic aspects may reduce the potency of various drugs. Some preparations may reduce libido and cause depression, others may reduce perspiration and thus cause heat intolerance. All these aspects are often forgotten in the heat of battle with multiple sclerosis.
Another popular side effect that specialists meet him in Symptomatic Treatment of Multiple Sclerosis is that not all necessarily symptoms are the result of Multiple Sclerosis Disease. Frequently, hands paresthesia is proven to be due to carpal tunnel syndrome and no central demyelination. An astute physician must be on guard for possible development of brain tumors or aneurysms in patients who were diagnosed as having multiple sclerosis. Thyroid and vitamin B12 deficiency may occur more often in patients with multiple sclerosis. It is therefore necessary to have in consideration other medical conditions when are treating multiple sclerosis patients.
Improving the quality of life of patients with Multiple Sclerosis with symptomatic management is something that is worthwhile and patients will be grateful for life for a forward approach of their problems.
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Most times, this can be remedied by introducing drug deeper into the subcutaneous tissue. In time, even if the product is placed deep, redness tends to disappear, but almost inevitably lipodystrophy atrophy of subcutaneous tissue nodules and cavities can occur after several years of treatment. The skin itself becomes rough and tough, the patient is starting to have problems in finding a place to inject the medicine.
Approximately 10% of Multiple Sclerosis patients who are using glatiramer acetate can develop several reactions after the injection treatment such as dyspnoea, chest pain, sweating and fear of death. This severe reaction lasts about 20 minutes but can be extended for a few hours before they are spontaneously disappearing. It is important for all Multiple Sclerosis patients to be educated about this side effect in order to avoid requesting emergency services and associated expenses. Reassurance is the best treatment, even if sometimes seems to be very conservative.
Interferons (both beta-1a as well as beta-1b) can causes dramatic skin reactions, but by initiating therapy with lower doses and escalating further slow, these reactions can be minimized. Some patients with Multiple Sclerosis may have need a month to reach the maximum dose with good tolerability. Flu-like symptoms are common at the onset of treatment and also can be spared by slow titration of dosage. Although lipodystrophy occurs to interferon, it is much more rare than in the case with glatiramer acetate, which can be explained simply by the less number of necessary injections. Interferon-beta 1a intramuscular injection does not cause skin reactions, but flu-like symptoms can be exaggerated. It is required monitoring of blood count and liver function, with dose adjustment if it is necessary.
Administration of natalizumab in patients with multiple sclerosis can cause allergic reactions which will stop the treatment. Anaphylaxis can occur occasionally and can reduce normal immune defense which will lead to opportunistic infections. Mitoxantrone has been associated with heart failure and leukemia. Doctors will be monitoring these pathologies by ultrasound, blood tests and observation. Therefore, treatment of symptoms is an ordeal in every treatment available.
Conclusions
Generally, Multiple Sclerosis Treatment, philosophy is to determine each patient cope better as far as possible with any disability / symptom that he / she has. This means treating disease, disease symptoms and the patient who has the disease. This is a philosophy of action. However, it will take into account the maximum care "primum non nocere" (no damage). Sometimes doctors use aggressive combination of a lot of medications used to treat a myriad of symptoms. Patients with multiple sclerosis, otherwise like all other patients, desires to treat all their upsets and doctors prescribe them properly. Metabolic aspects may reduce the potency of various drugs. Some preparations may reduce libido and cause depression, others may reduce perspiration and thus cause heat intolerance. All these aspects are often forgotten in the heat of battle with multiple sclerosis.
Another popular side effect that specialists meet him in Symptomatic Treatment of Multiple Sclerosis is that not all necessarily symptoms are the result of Multiple Sclerosis Disease. Frequently, hands paresthesia is proven to be due to carpal tunnel syndrome and no central demyelination. An astute physician must be on guard for possible development of brain tumors or aneurysms in patients who were diagnosed as having multiple sclerosis. Thyroid and vitamin B12 deficiency may occur more often in patients with multiple sclerosis. It is therefore necessary to have in consideration other medical conditions when are treating multiple sclerosis patients.
Improving the quality of life of patients with Multiple Sclerosis with symptomatic management is something that is worthwhile and patients will be grateful for life for a forward approach of their problems.
