Dystrophin plays a role in muscle function and without dystrophin, muscle tissue will be replaced with fibrous and adipose tissue. Casimersen is an antisense phosphorodiamidate morpholino oligonucleotide designed to bind to the exon 45 of the DMD pre-MRNA, which prevents its exclusion into the mature RNA before translation. This change causes the production of an internally truncated dysphotrophin protein. Dosage and administration
The usual pediatric and adult dose for Casimersen, for treatment of muscular dystrophy is 30 mg/kg via IV infusion once a week. Adverse effects
Patients on Casimersen are advised to immediately contact their healthcare team if they experience the following side effects: pink, brown, or foamy urine or swelling of the hands and feet. Common side effects include: headache, fever, joint pain, cough and cold symptoms. References
External links
"Casimersen". Drug Information Portal. U.S. National Library of Medicine. Clinical trial number NCT02500381 for "Study of SRP-4045 and SRP-4053 in DMD Patients (ESSENCE)" at ClinicalTrials.gov
Nasal intubation, inserting an endotracheal tube through the nose, may be contraindicated in the presence of facial trauma because if there is an undiscovered fracture at the base of the skull, the tube could be forced through it and into the brain. If facial injuries prevent orotracheal or nasotracheal intubation, a surgical airway can be placed to provide an adequate airway. Although cricothyrotomy and tracheostomy can secure an airway when other methods fail, they are used only as a last resort because of potential complications and the difficulty of the procedures. A dressing can be placed over wounds to keep them clean and to facilitate healing, and antibiotics may be used in cases where infection is likely. People with contaminated wounds who have not been immunized against tetanus within five years may be given a tetanus vaccination. Lacerations may require stitches to stop bleeding and facilitate wound healing with as little scarring as possible. Although it is not common for bleeding from the maxillofacial region to be profuse enough to be life-threatening, it is still necessary to control such bleeding. Severe bleeding occurs as the result of facial trauma in 1–11% of patients, and the origin of this bleeding can be difficult to locate. Nasal packing can be used to control nose bleeds and hematomas that may form on the septum between the nostrils. Such hematomas need to be drained.