MS: Acute severe attack
  • Methylprednisone (Solumedrol): 1 gram iv infusion per day x 3 to 5 days
  • Followed by oral Prednisone taper
    • 60 mg qd x 7 days, then 60 mg qod x 7 days, then 40 mg qod x 7 days, then 20 mg qod x 7 days, then stop
  • ? H2 blocker for ulcer prophylaxis
  • Monitor blood glucose
  • Watch for infection

 

Multiple Sclerosis Symptomatic Treatment
Fatigue & heat sensitivity
  • Amantadine (Symmetrel): 100 mg bid
  • Pemoline (Cylert):
    • Chewable tab: 37.5 mg, Tab: 18.75, 37.5, 75 mg
    • dose: 18.75 mg - 37.5 mg am
    • use for short term
Neurogenic bladder: uninhibited, small capacity
  • Physical measure
    • void on schedule q3h
    • Intermittent catherization
  • Propantheline bromide (Pro-Banthine)
    • tab: 7.5, 15 mg
    • 15 mg qid, increase gradually
    • anticholinergic side effects
  • Oxybutynin (Ditropan)
    • tab: 5 mg, syrup: 5 mg/5ml
    • 5 mg bid, max 5 mg qid
    • anticholinergic side effects
  • Detrol (Tolterodine)
    • usual 2 mg bid
    • less dry mouth, reduce dose to 1 mg bid if liver dysfunction or on macrolide antibiotics or antifungal agent

Multiple sclerosis info center
Multiple sclerosis overview

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