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MS - block 6

Pharm'14 block 2

Glatimer Acetate (copaxone) May promote proliferation of T2 helper cells (neuroprotective), compete with myelin basic protein thereby inhibiting re-activation of the T-cells in the CNS RRMS CIS Lipoatrophy (dimpling of skin) injection reaction chest pain (tach, SOB, CP) not immune suppressing NO lab monitoring: big benefit
Fingolimod (gilenya) sequestrating of lymphocytes into the lymph node thus decreasing lymphocyte migration into the CNS RRMS Low WBC -> around 2 1st degree heart block bradycardia macular edema Cardiac Problems immune suppressing monitor 1st dose EKG monitor: CBC, LFT, OTC every 3-6 months
Natalizumab (tysabril) binds to the surface of Tcells, Bcells and macrophages -> prevents movement across the BBB JC virus activation -> PML infections infusion reactions elevated LFTs prescreeen LFTs and JC virus
Dimethyl fumarate (tecfidera) unknown: thought to decrease activated T1 helper cells (proinflammatory) and increase T2 helper cells (neuroprotective) RRMS GI upset (30%) N/V/D Flushing; eat w/ meal or take ASA elevated LFTs prescreen: CBC Monitoring: CBC, CMP
Teriflunomide (aubagio) inhibiting pyrimidine synthesis -> decreases proliferation of T and Bcells in periphery RRMS elevated LFTs Alopecia Diarrhea BBW: sever liver dz Preg X prescreen lab: LFTs, CBC, TB monitor LFTs monthly for 6 then every 6 slowly eliminated from plasma (8months - 2yrs)
Interferon Beta 1a (avonex) Not sure-> Think: decrease TCell proliferation, decrease antigen prentation, andalter cytokine release which reduces the number of cells that cross through the BBB RRMS CIS Flu-like sx depression -> ceases within months injection site reactions elevated LFTs Hypothyroidism Not immune suppressing Monitor : CBC, LFT, TSH
Created by: duanea00