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MS Drugs

Multiple Sclerosis

QuestionAnswer
two main groups of disease-modifying drugs: immunomodulators and immunosuppressants
immunomodulators include: interferon beta, glatiramer acetate, natalizumab, and fingolimod
mitoxantrone the major immunosuppressant in use
If treatment with an immunomodulator fails to prevent severe relapses or disease progression, which drug should you use? Mitoxantrone
What are some side effects of Mitoxantrone? myelosuppression and heart damage. Only give it to those who really need it.
Mitoxantrone is approved for which disorder? Progressive-Relapsing MS
What can Mitoxantrone do? Mitoxantrone can decrease clinical attack rate, reduce development of new brain lesions, and slow progression of disability. However, although the drug is effective, cardiotoxicity precludes long-term use.
How do you treat an acute episode of MS? A short course of a high-dose IV glucocorticoid is the preferred treatment of an acute relapse. Glucocorticoids suppress inflammation and can thereby reduce the severity and duration of a clinical attack.
When do we use IV gamma globulin? When the patient is intolerant of or unresponsive to glucocorticoids. Results have been good.
Seven immunomodulators are available: glatiramer acetate [Copaxone], natalizumab [Tysabri], fingolimod [Gilenya] and four preparations of interferon beta [Avonex, Rebif, Betaseron, Extavia].
Which MS drugs are used first? All except for natalizumab.
Why is Natalizumab not used first when treating MS? Why? Because, very rarely, natalizumab has been associated with a potentially fatal infection of the brain.
Which of the first line drugs is most effective? All of the first-line immunomodulators—glatiramer, fingolimod, and the interferon beta preparations—have nearly equal efficacy, decreasing the relapse rate by about 30%.
How effective is Natalizumab? Natalizumab is very effective(decreasing relapse rates to 68% vs. 30%), but is also very dangerous.
Route of administration forli first line MS drugs All are given IM or SQ except Fingolimod.
Describe an Interferon beta Interferon beta is a naturally occurring glycoprotein with antiviral, antiproliferative, and immunomodulatory actions
How do Interferon Beta work? First, it inhibits the migration of proinflammatory leukocytes across the blood-brain barrier, thereby preventing these cells from reaching neurons of the CNS. Second, it suppresses T helper cell activity.
What can interferon Beta drugs do? These drugs can decrease the frequency and severity of attacks, reduce the number and size of MRI-detectable lesions, and delay the progression of disability.
What are some adverse reactions of INTEFERON BETA drugs? Flu-like reactions, Hepatotoxicity, Myelosuppression(bone marrow function supression), Injection-site reactions(pain, erythema, bumps, and itching).
Based on the adverse reactions caused by interferon beta drugs, what drugs should be avoided? Exercise caution when combining interferon beta with other drugs that can suppress the bone marrow or cause liver injury.
List all four interferon beta Avonex, Rebif, Betaseron and extavia
Therapeutic use of Glatiramer acetate Glatiramer acetate [Copaxone], also known as copolymer-1, is used for long-term therapy of relapsing-remitting MS. It does the same things as interferon beta drugs.
What are the first line drugs for Ms glatiramer acetate, natalizumab, fingolimod and four preparations of interferon beta [Avonex, Rebif, Betaseron, Extavia].
What is different about Glatiramer acetate? Unlike interferon beta, glatiramer does not cause flu-like symptoms, myelosuppression, or liver toxicity.
Natalizumab most effective drug; not used first because if can infect the brain
Created by: ekm
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