Patients who failed other therapies
MOA: Topoisomerase II inhibitor
Max dose: 140 mg/m2
Can be used: with all disease modifying agents except natalizumabMitoxantrone
USe:
MOA
Max dose
Can be usedCardiotoxicity (Must have EF > 50% prior to each infusion)
severe bone marrow suppression (CBC prior to each infusion)
teratogenic (have to have negative pregnancy test)
Common AEs
- nausea, alopecia, infection
- Blue-green urine for 24 hoursMitoxantrone
BBW's
Common AE'sfailed 2 or more therapies
IV --> two dose cycles then done forever typically
increased risk of infection
increased incidence of autoimmune disorder
Common AE's
- infusion reaction (premedicate with methylprednisolone)
- thyroid dysfunction
- blood clotting disorderAlemtuzumab
Use
Administered
Common AE'sin combination
patients who had an inadequate response to ≥ 2 therapiesSumming up
Mitoxantrone is typically used...
Cladribine and alemtuzumanb are forGait or walking = dalfampridine
Spasticity = Baclofen or Tizanidine
Bladder = Tolterodine / Oxybutinin
Sensory = Gabapentin
Fatigue = Amantadine / Modafinil / MethylphenidatePrimary symptom management
Gait or walking = dalfampridine
Spasticity =
Bladder =
Sensory =
Fatigue =
