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From Pharmacy Times
Thanks to the author Craig I. Coleman, PharmD(Dr. Coleman is an assistant professor of pharmacy practice and director of the pharmacoeconomics and outcomes studies group at the University of Connecticut School of Pharmacy.)
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New MS Treatment
AC is a 41-year-old white woman with relapsing-remitting multiple sclerosis (MS). She has been receiving interferon beta- 1a (Avenox) 30-mcg intramuscular injections once weekly to manage her disease. Recently, AC began complaining to her neurologist of walking difficulty. Today, AC’s neurologist gave her a new prescription for dalfampridine 10 mg twice daily. When AC approaches the counter, she asks the pharmacist, “I have been taking the same drug to treat my MS for a long time now, why all of a sudden do I need another one?”
How should the pharmacist respond to AC?
Answer:
MS is a chronic, often disabling disease that affects the central nervous system—the brain, spinal cord, and optic nerves. There are about 400,000 people in the United States and 2.5 million people worldwide diagnosed with MS. The FDA recently approved dalfampridine (Ampyra) extended-release tablets to improve walking ability in patients with MS. This is the first drug to be approved for this indication. Dalfampridine is a potassium channel blocker and thus improves conduction in demyelinated nerve pathways via its blockade of voltage-dependent potassium channels. The pharmacist should counsel AC that her interferon is a disease-modifying therapy, which is used to decrease the number of attacks she experiences and reduce progression to disability. Her new drug, dalfampridine, is specifically used to improve walking ability in people with MS and has only recently become available. Her neurologist likely prescribed it because of her complaints about walking difficulty. AC should be reminded of the importance of continuing both medications prescribed to her by her neurologist.
治疗多发性硬化新药
AC,白人女性,41岁,复发型多发性硬化症。一直以来使用干扰素ß-1a 30μim. qw治疗。最近AC向其神经科医生抱怨出现行走困难。今天,AC的神经科医生为AC开了新药dalfampridine 10mg bid。AC来到柜台问药师,“我使用同一种药物治疗MS已经很长时间了,为什么突然又加一种呢?”
作为药师应该如何应对AC的提问呢?
回答:
MS是一种慢性、机能减退性疾病,累及中枢神经系统,包括大脑,脊髓和视神经。在美国大约有40万,全球约有2500万患者。FDA最近批准了dalfampridine(Ampyra)缓释片剂用于改善MS患者的行走能力。这是首个获批用于此适应症的药品。dalfampridine作为钾通道阻断剂是通过阻断电压依赖性钾通道从而提高脱髓鞘神经传导。药师应该向AC解释干扰素作用是改变MS疾病病程,即减少发作次数和延缓机能减退进程的。最近上市的新药dalfampridine则专门用于改善MS患者行走能力。她的神经科医生很可能是因为她抱怨行走困难才开这种新药。AC应坚持这两种药的联合治疗。 |
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