MS drugs Flashcards
diemethyl fumarate warning and ADR
leukopenia, fushing redness, rash
warn: liver toxicity
metabolite of dimethyl fumarate
MMF - a nictotinic acid receptor agonist
fingolimod MOA
sphingosine 1 phosphate receptor modulator
keeps WBC in ymphnodes so don’t cross BBB
ADRs for fingolimod
varicella zoster, PML, abnormal LFTs, cough, increased mortality
Teriflunomide moa
pyrimidine synthesis inhibitor: inhibits immune cells
teriflunomide is only indicated for..
relapsing forms of MS
teriflunomide 6+ warnings
hepatotoxic, teratogenic, bone marrow suppression, peripheral neuropathy, high K, transient renal failure
adr: alopecia, D/N, messed up LFT
what is dalfampridine MOA and niche
MOA: potassium channel blocker
- increases condition of AP in demyelinated axons
indicated for walking improvement
2 contraindications of dalfampridine
renal impairment, and seizures
what do you need to monitor with IVIG?
renal function
dontrolene is a ___
muscle relaxant - used in spasticity in MS
dantrolene first line for and CI
malignant hyperthermia
CI in active liver dz
nuedexta is first line for
pseudobulbar affect in MS
what combo is nuedexta?
dextromethorphan and quinidine
METABOLIZED BY 2D6
yet quinidine is a 2D6 inhibitor so increases BA by 20 times so dextro can crosss the BBB
dextromethorphan half life goes from 2 to 13 hours
nuedexta CI
long QT, AV block
interferon b treats
RRMS or SPMS with relapses
main ADR: 48 hrs of flu
glatiramer acetate main ADR
lipoatrophy and skin necrosis
Mitoxantrone unique facts
blue drug
used to do chemo - toperimase, PReg D
besides MS what does mitoxantrone treat?
hormone refractory prostate CA
acute leukemia adults
mitoxantrone ADR
cardiotoxicity CI if LVEF is less than 50%
natalizumab moa
binds up wbc in lymphnodes so cant go in BBB
used in combo with interferon
delays disability in relapsing MS
warnings of natalizumba
PML
limited use .. need restricted program for rx
