MS Flashcards
Beta interferon and glatiramer acetate
Traditional agents (platform agents)
Main SEs are flu-like sxs. Malaise, H/A, fevers, myalgia so, elevated liver enzymes
Beta interferon
SEs include injection site rxs, lipoatrophy, injection related chest tightness, SOB, and flushing
Glatiramer acetate
Can develop neutralizing antibodies to
Interferon beta
Fingolimod, teriflunomide, and dimethyl fumarate
Oral therapies for MS
Sequesters lymphocytes in LNs
Fingolimod
Superior to low dose interferon. Most common side effect is H/A and lymphopenia
Fingolimod
Can cause significant bradycardia and hypotension so first dose must be monitored in doctors office or hospital
Fingolimod
Limits an enzyme in pyrimidine synthesis in lymphocytes. Blocks proliferation of activated T and B cells responsible for inflammation in MS
Teriflunomide
Can cause teratogenicity. Must be removed from system in pregnancy with cholestyramine
Teriflunomide
Causes alopecia by resetting hair cycle and hepatotoxicity risk
Teriflunomide
Activates Nrf2 pathway involved in cellular response to oxidative stress
Dimethyl fumarate
Causes flushing and diarrhea
Dimethyl fumarate
Humanized monoclonal antibody. Targets alpha-4 integrin and blocks trafficking of Leukocytes across BBB.
Natalizumab
More effective than first line treatment, but used as second line b/c of risk of PML
Natalizumab