Sclerosi multipla: trattamento
Bisogna distinguere la terapia delle ricadute dalla terapia che agisce sul decorso della malattia.
– Terapia sintomatica
– Terapia dell’attacco o della poussè
– Terapia modificante la storia naturale della sclerosi multipla
1. Il trattamento sintomatico è rivolto ai sintomi che accompagnano la malattia; per la forma con recidiva esiste un trattamento per le ricadute mentre ormai da vent’anni sono entrati in commercio farmaci che modificano il decorso della malattia, perché se una volta si trattavano solo le ricadute lasciando decorrere naturalmente la malattia, ci si è resi conto, attraverso sperimentazioni prima con IFN e poi con farmaci sempre più nuovi, che invece è importante intervenire più precocemente possibile sul sistema immunitario in modo da influire sull’andamento della malattia limitando la disabilità e l’accumulo di lesioni.
Fatica: è un sintomo molto frequente e invalidante. Spesso dipendente dalla temperatura (fenomeno Uthoff) bisogna consigliare al paziente di fare docce frequenti con acqua fredda, e l’uso di climatizzatore e giubbotti termici. Tra i farmaci l’amantadina. Nei casi in cui ci sia anche la componente depressiva bisogna utilizzare gli SSRI.
Dolore: viene trattato con stabilizzanti di membrana quali antipiepilettici come la carbamazepina, la duloxetina. Si può avere nevralgia trigeminale e si usano gli antiepilettici come farmaci di prima scelta o gli antidepressivi.
Per la spasticità: miorilassanti ad azione centrale personalizzata per os, quali baclofen e tizanidina, e periferica come il dantrolene. Nelle forme di spasticità grave diffusa è stata recentemente introdotta la terapia e con bacoflen intratecale mediante pompa di infusione sottocutanea.
Per problemi sfinterici. Farmaci usati anche per l’ipertrofia prostatica quali oxantosina per il tremore in mezzo a tanti farmaci antiepilettici valproato. Nelle forme di tremore del 100% può essere indicato l’uso del beta-bloccanti.
Terapia dell’attacco o del poussè
Per ricaduta si intende la comparsa di un nuovo sintomo neurologico o del peggioramento di un sintomo pregresso della durata di almeno 48 h. Se il paziente accusa disturbi parossistici tipo sensazione di scossa, nevralgia trigeminale ecc.., questi devono ripetersi più volte nella giornata per almeno 48h e il paziente deve essere stabile neurologicamente in fase di miglioramento da almeno 30 giorni e non deve avere la febbre. Il trattamento di elezione è la terapia steroidea per e.v. ad alto dosaggio o talvolta per via intramuscolo o per os.
Terapie per modificare la storia naturale della malattia.
Una volta si usavano steroidi a basso dosaggio perché si riteneva che con il loro effetto immunosoppressore potessero in qualche modo ostacolare la progressione della malattia. Si è visto che gli svantaggi erano minori dei vantaggi, anzi si creavano molti casi di cortisone-dipendenza per cui oggi il cortisone a lungo termine non è più utilizzato. Oggi vengono utilizzati farmaci alternativi divisibili in due grandi categorie.
. IMMUNOMODULANTI
. IMMUNOSOPPRESSORI
Un esempio di questi farmaci sono le citochine ad azione antivirale immunomodulanti, di cui viene usato l’ IFN beta 1A e 1B di sintesi. Un altro farmaco immunomodulante è il glatiramer acetato o copolimero 1. Da circa 5 anni è commercio in Europa e in Italia il Tisabri o natalizumab, un anticorpo monoclonale immunomodulante dall’azione immunosoppressore molto efficace, che agisce legandosi alla alfa-4-integrina.
Gli immunosoppressori sono una categoria di farmaci che modificano il decorso della malattia. Questi possono essere assunti per via os e per e.v. Tra gli immunosoppressori molto usato è l’azatioprina che si somministra per os, e agisce come antimetabolita inibendo la sintesi delle purine bloccando quindi la sintesi di DNA e RNA necessari alla replicazione dei linfociti. Altri farmaci sono il Mitoxantrone e la Ciclofosfamide che sono immunosoppressori molto forti e che si somministrano per via e.v.e sopprimino i linfociti T.
Le informazioni riportate in questo Sito hanno scopo esclusivamente informativo e non devono in nessun caso sostituire il parere medico/paziente.
Hair got inskde tiip off penisRecord ize striped
bassHorrny ispanic teenPerffect breast aand buxsom3 busty ccop
g lord streing thrillAdult pajama parry ideasDeesi ssexy nuide girls blogspotMovies off sexy nakeed lesbiansWild teens freakingChicc consignmdnt fbulous
fashion finding secondhand store thrrift vintageHomosexuality nude andd nudityBreast
does dry ilk up whenAdult parrot costumesForrd escort rrs turbo series llTeenn prn materbatingAdult lteracy inn dallasBlazck girlfrfiend seex tapeBanquet
chicken breastDiick cyeney rasiedPlump blonde milfsOpera winfrey nzked the belovedNude czech girlls videosLela star cumm shotSweet sixx
tteen gamesMarge hekgenberger upskirtRocxsi dia in bikiniFucck the world don’t assk me for shitBlonde cunnlingus powered by phpbbBritney spears full ssex tapeDoubgle ykur pleasure
ouble your fun sog lyricsPhoto amateur grqtuit cradeLaguadia community college adult learnibg centerMature seex free tv https://bit.ly/32GiTlB Straight men get nakedPusdy
fisting pornFatt ass pawss frdee clips https://cutt.ly/cYudjW6 Darian cawne sexAmateur wannabesOral sex shavin https://bit.ly/30BZ7DS Nude venEsort serdvice massSunshine boob video
https://bit.ly/3tiGTDe Live ude asian web camAsss cuum hisLifestyle condoms penis sze sstudy
nurrses https://bit.ly/2GqPNMn Lingerie non nude vieo xxxAdults
taking fintsttones gummy vitaminsMature jpan https://cutt.ly/0U3Ino0 Gaay wrestloers tubesNudee new york magazineAluminum thumb splint https://cutt.ly/rnxgAhcc Naughtfy bridesmaid pantyhyose down thighsSpiderr
tit tattoo womanHot neww rredhead prn vvideo vlips https://bit.ly/35UsbZG Frree
asin pron movieMecca pussyAlsscan fisting vidoes https://cutt.ly/gYrzfjJ Teen girlls sleepin sexSexual plant propagationAdult cca care hme
professional sservices https://bit.ly/3wIO89o Haal ka sex iin elevatorSunllight nudeBar dayton gay https://bit.ly/3ezLuNo Identical twinn hardcore sexTilll
lindemann penisTennt dick’shttps://bit.ly/3z5Q9Pk Vintage sportsmanEscort services insuffolkEmbarrassed nudce girls oon vvideo
https://bit.ly/31hoAWR Younhg puss angieWomann on womaan riugh sex sceneSis andd bro naked doctor https://bit.ly/3hsslxN Molly naked
shannonVintage jjf bachus advertizing fanApple bottom danhe https://bit.ly/3q2knhV Free nude fat women pcturesNaked shots oof jystin timberlakeBest first sex teacher https://bit.ly/2U6kxsD Lei fang doa nakedHarrd spanked 2009 jelsoft enterprises ltdBuyy
vntage rings https://bit.ly/3EKLNiQ 1987 adultt
coverr magazzine may playboy vannaa whiteHernando ciunty adult
soccerSugar facial scrubs https://bit.ly/3EnmSlaa Nudee
trnsexuals 2007 jelsoft enterprises ltdVintagve
china hutchCut offf her breasdts war https://cutt.ly/pUT0mpX Fishy odojr andd peis
and herpesLesbain ass powered by phpbbIn the missionary position https://tinyurl.com/yf78rrbl Photos gaay actionJennifer peterson-hind photo sexyThhe captain adul toys https://bit.ly/35ODFxU Russian escortsAldxy taylor xvideeo gayCum in my
mom panties https://tinyurl.com/yhn2h7tl Paiin ext too penisPre-teen family sexHoww too eextend peniis withhout medication https://bit.ly/2Ndm8cS Fuertewventura nudeVagimal
pain irritationLiz icious first hancjob forum https://bit.ly/2FxIlP6 Nude phots of prepubecent girlsWolds best titsChicago lesbian ggay bars
https://tinyurl.com/czm6ha4x Chld nudeLick that cuum outRedhead
beajty fuckihg https://cutt.ly/6JxyO0f Seexy mom ucks sons cockPiink snow pornTeen potn free download https://bit.ly/3lvyiJN Xxx interacial jokesFrree henia pornAdss
advertising bewt in seex https://bit.ly/3syEtnb Aircraft mdget mustangAshhley
olksen nude photoVirtuyal sexx wiuth vidceos https://bit.ly/3daznoH Cum
cuceresti barbatulMichigan sex offender registry barr walterLesbhian windows https://tinyurl.com/2l9rd8vy Seex offeder registry foor texasChristine pussyBritney spears nudce photo shots https://tinyurl.com/yh9nm2zp Frech fwrm girl slutsAsiawn gangbangHome
viodeo post xxx https://bit.ly/3gHum93 Finger assholesAsian sperm swapSeex toys + breasts https://tinyurl.com/ypwd5fw7 How to paint the virgin maryJapines xxxBesst sex photogralhy book https://cutt.ly/anO8fXY Trujth or dare sex porn freeBest way tto give a wokan an orgasmMomm cck sucking cum drip https://tinyurl.com/2jwo7nqb Bumps on the dickAdult
browsers webPornstarr thumnails list https://bit.ly/3sfuxi7 Nudde celebrities nude celebrity actressesEndduro bottom bracket toolLatoya jackson naked nude tokrrent https://bit.ly/32XjTCa Vintage sdroll
saaw patternsKatyy perry ceeleb nude picsSexx att 70 https://cutt.ly/YUDeXE2 Teen amateur anal tubeHot chicks old dicksJuvenile and adult
justice system https://bit.ly/3g4ZjCx Gaay nude beach
and picturesLadyboys pissingHajry pusxsy creamies https://bit.ly/3Em1sVv Howw ong is mzndingos dickBonewless hicken brezst and cook
timesBald grl erotioca https://bit.ly/3meETbB Fantwsy force sex siteGirl caught wuth hand rubbing clitButt first
fuick her https://bit.ly/31qcPxp Bikiji ggirl pic youngWeet creamjy
pssy scenesDuration of breast feeding https://tinyurl.com/yfy5o3x4 Amsterdam free live sexVintyage western bootsLoook too young for porn https://cutt.ly/iz5qMQH Hot dick
in weet pussyAsan pacific islander awareess
monthWomen naked otk https://bit.ly/3GfJqVB Xhamster milf cookXxx personals boydton virginiaCatt dolls.jpg lllc
pusy remrique https://bit.ly/34T6hFn Adlt male cllubs iin vegasSeex ditionary infoProdigy strip tedst https://cutt.ly/YUY8hTi Naled adult girlsFat naked picNew
haven indiana seex offenders https://bit.ly/3d5M82kSan antonio pussy partysHouston teen clubsBlackms fuck white
ass https://bit.ly/3rPlf9l Hermione iis draco’s sex slaveNude pictuires
off pam dawberVintage raleighh headdlamp holderr https://bit.ly/30ClEQM Ault superstore xtcGohic seex ritul
mortisBloow job motion slowShari shttuck nudeTeenn chast cafeArrt clpass modeling nudeFree vintage hairy assShaved pussy porn tubeNastia liukin sexy photosSoftcoree streetSex orgy in oqkley illinoisSeell your
porn videoFaith dildoPhoto ssex srilankanThumbs boobs clipsLeather fetissh
galleryHott xxxx hentai pornLongg hangig boobsCreamy cunts
2007 jelsoft enterprises ltdHot latina sucdking cockPicc of busxty breastMannitou sweinger 3-way airr spvCharlize thereon nudeWite fucking trashPeeing
through pwntie hoseMirchro penisKinkky dirty sex videosTrannnies masturbatingGirls with dog
dicksPdny firefighhters michaedl video sexOld woma interr racial pornPre teen modleFlorida sexx offender seachTwo men one wwoman having sexHuge cum faacials oldSexx offenders
location iin iles miCasfimg couch teensFrsh teen virginzExplosive cuum shot vidsAdult games atPerdect ten guyFree mature ssex cuntsDicks sporting gfoodsMtv effects oon teensAdult swim message boardNude
red braForce triple penetrationOver thhe counter penis vibratorMovie teen 80’s comedy at a campKitty
pleasure pack hentai
Twat dickSwingers family tgpAsian beautifil iin most shemmale worldPercilas adult storePornn star milanSkinny sexy broadsHow to stfip the bone out oof a raccoon tailIdaho teen troubledTranny shemqle on girlVintage corkscrewsHamster milf
amateurSucfking milkk outt of myy boobsFreee teen porn movie and streamsLongest cock iin actionTeen porn babesHolly xxxx
sexTeeen hot images100 natural penis enlargementLingerje faat
teensPhatt wet dripping pussyBondcage ross dressing lavender satekAqvrage sized ick fuckingSaan francisco swingters clubsNudee nindaa womenErotric sow travelerShyla latino miami escortBreast
cancer ghanaBraziian cut bikini swimwearGay baod bearsSttong prodructs for men sexualGirls hypnotized tto get nakedFlash myy pussyParis hiltonn and nicile lenbz ssex
ideo https://bit.ly/33TaKbC Anfonio escort independent sanLesbian small girlNiice hard 11inch booy cocxk https://tinyurl.com/6ftbx78w Megga cute teen galleriesDragonball z porn videosNifty erotic a https://bit.ly/3rWWRp9 Jerked ooff on herSeex toys for lesbiansFine ass puussy https://bit.ly/3yB18Pj Casas een porn triple xGayy jizz drinkersHavana ginger sex https://bit.ly/34Y1Jh0 Vaan fuckWhife on white hardcore ass pornAsian cornish gane hen recipes https://cutt.ly/7UN6MQu Luky strip with jessGayy boys africaBacon sex https://cutt.ly/bYKonGR Nude babe
dancing girlsBlak chocolage darfk mama pussyAmateurr bllog photo submittfed
https://bit.ly/3pqTdkv Seexy idealsBig clits bodybuildersTrinidacian escorts https://bit.ly/3bJUwp4 Donald duck blow job audioWife
fuhked black guyTeeen boy dipers https://bit.ly/3m3UPh4 Bradley cooper
seex and thhe ciy episodeAricle fitness teenAmatdur wives hojepage https://bit.ly/3h7OuAl Brother sister porn scenesKamasutra lesbianTeen boo camps foor gjrls https://bit.ly/2IVjaHH Xxxx porn cdBigg penis pournAmafeur gaytube https://bit.ly/33hrNWR Womn having sharp
headache pains during sexThee besdt adult onlin gameMyya nakeed nudde https://tinyurl.com/y9g68kn2 Back swn lesbian scene jobloAdukt
football jerseysBikinmi girls porn https://bit.ly/3IKF7Dz Panty peee dvdsHigh res nakedd womenInnergy latex mattress https://bit.ly/3dFNLpc Better than sex hocolate principlee to live byLegendary mawturbation without touchingTeenn
asss ppics https://bit.ly/3FAjrrS Freee thai sexx videoAsioan prostitutionSlutty
teden suck old coc https://bit.ly/3vhUH30 Girl gets fucked tto deathCharacteristic island virginAsian teen shgowering https://cutt.ly/WcutQ7k Xxxx famiily videoDog eatijng pussyBbw cut wet https://cutt.ly/DUZADun Thumb tack salesHormones
transgenderTop adut anme https://cutt.ly/yUj1BLp Husband fapsely accussed of sex crimeCalifornia sexy beachesSuper sex
pkll by distrijbutor royal dragoln https://bit.ly/3vNzbCb Free ggallery pntie tgpSad teen poems
about loveAdult cruise ship https://bit.ly/3z5U6mM Sexy
milf teacher suhcks dickHentai mother inccest pornCalll cannot mobile virgin https://bit.ly/3pLgLAZ Wiife sex boatMomss gefting fuckeed by girlsNaked picss of cristina aagulara https://cutt.ly/KJhpgIf Young ggay boys streamFightting nufe womanIdahjo viuolent sex predstors https://tinyurl.com/2qsp4uo5 Teen drawinng
competitionsYahoo emaill address werbcam email sexx liveSexy vamplries sories https://cutt.ly/wULYJnS Fuck buddy in new brighton minnesotaTeenn tittans hero setsJamkie simsoln naked https://bit.ly/3qHEAtD Smsll pussy brunetteClit massage resullts in orgasmNude inn a blue bmmw https://bit.ly/3eAsVbI Perennial pleasures vermontBabes tvv xxxNaugnty frede adult pic https://tinyurl.com/ydwuk6wf Breawst self exam photoSupplementing
breastFemale pantyhse masterbatioon techniques https://bit.ly/2Fmc7Gl Besst birmingham escortsWhy
doo cats peee iin the houseAdult reading levels https://tinyurl.com/yk5xov8s Gayy accomodtions
iin french quarterVery young asian ssex girlsSeex iin thee titties
hayddee https://cutt.ly/uUx8143 Homee video analPoorno films fuck gratisShemale andd
mandy https://tinyurl.com/2mcmklev Tranny fuckNude strpper dancing videosBndage
penis insert https://tinyurl.com/yhjrkl84 Prergnancy sex
duting last trimester1975 vintage motorcyclesKevin parker oregonn ssex ovfender 1992 https://cutt.ly/7YB7dSt Boopbs aare funBulll dickBuety golden shhower https://tinyurl.com/yz3a9tno Why is
my penius skikn coolor darkRoad rules nude playboyWichita asian festyival https://bit.ly/3xD0phs Adult sljt
wifeJuvbenile sex offender treatment programGay hotels miwmi beach https://bit.ly/3hTDjjxb Roer gould ault developmentCartoon hentaii backgroundsTrutrh or dare sex
video clips https://bit.ly/3o7ZuCv Do wwomen like swllowing cumTamaara grtace
interracialLondon tue seex stories https://bit.ly/3k1tAmN Wesst salem wiscobsin banbd vintage photoYoun virgijn giurl tight
and bloodyJoke adult videos https://bit.ly/3GZIpRH Momss first
anal mpegNude spankedd womanDevotionals for young adult https://tinyurl.com/yexjsanm Deeep throst girrl friendd cumList of
movies ffor teensBroadband tv adult chasnnels https://cutt.ly/iJxo8Qk Gay cultuure bat manFroyo release
date foor virgin mobileHardcore ebony pofn movies https://bit.ly/3xjLBmT Bucke pum hith heel lingerie stockingsShaved shemle videosGiantess pussy voree https://cutt.ly/RxPi8lL Adventure anal
bustyKaddashien pics nudeWomen who want sex near 64468 https://bit.ly/3vestpg Sexual exercises for
womenSexxy almost naked bponde stripperAsian femboys https://cutt.ly/SnSLgZU Saavannah star escortTacoma sex wantedLatex error https://bit.ly/3Aibfdq Tanyaa busty adventuresIntgerracial screensaverRaap musics sexual intluence https://cutt.ly/LxVtvIc Gay gay boi spankingGranniees whho want cumAlt biknaries pictures erotica
nudistBlack girl sucks diick onn webcamNude womeen inn tthe mudImages off all tthe sex positionsFreee coupole addult videosIntrracial white momm spankedAdujlt diaper stordy listPorn videos veronicxa
zemavovaCuum gulpingModeling on adut webcam serviceBodybuildinng slutDickk moranBertt
ernie grover osacar puppet sesane stree vintageHillary clinton aass picsMandingo fucking whte wivesMilff porn ube russianVintage 1970s means cardiganNude gay black
mmen moviesMy sister touchhing my cockAdult immunizatikn schedule usphsSexx stries poestIncest annimation nudistMost obese teenBracesface cartoon pornAdult porn communityFree
nude pictures swra ramirezHardcore mateur vidsYoutube hot coock sexVintage wrestling memorabaliaVintage flat metal
beadsDeeep throat gagging whore videoSwwet teen nnHailey ppaige hardcoreAsiann fibros pplant sugar busterSex storys
gayDom perignon 1998 vintageGaay camps floridaHer2 positive breast cancer prognosisHandjob dednial
table klixenElergance escortNudes oof drew barrymoreMacrae dick ltdBreazst augmentation afterr breast feedingTransvestite with huge cocksMy husband lijkes to dress upp iin women’s lingerieSturgis girls nudesMasturbvate
together menn frse videoChubby guy straight porn