Multiple Sclerosis Flashcards
What happens to the brain with the natural course of MS?
brain atrophy
What is most likely responsible for disability in MS?
Axonal involvement
Diagnosis of MS depends on demonstrating what?
attacks of neurologic dysfunction disseminated in time and space
Most patients with MS begin as what type?
Relapsing- Remitting
Untreated pts w/ RRMS typically progress to what type of MS?
Progressive
Name four interferons used for MS treatment.
Avonex, Rebif, Betaseron, Extavia
Name three treatments for acute MS
Corticosteroids, plasmaphoresis, ACTH
What is the MOA of interferons in MS
inhibit T cell activation, shift from Th1 to Th2 (non-inflammatory), inhibit lymphocyte movement into CNS, apoptosis of T cells, IFN antagonism
What interferons are high dose, low dose?
Avonex - low dose
Rebif, Extavia, Betasteron- high dose
What are added benefits of Rebif over other interferons?
reduces disability
What two interferons work on IFN beta-1a?
Rebif, Avonex
What two interferons work on IFN beta-1b?
Extavia, Betasteron
Of the interferons what has the greatest likelihood of causing Neutralizing antibodies?
Betasteron
SE of avonex
lesser than other corticosteroids because lesser dose
mild anemia, elevated LFTs, hypothyroid
monitor LFTs every 6 months
SE of Rebif, Betasteron, Extavia
anemia, leukopenia, elevated LFTs, hypothyroid, menstrual irregularities, depression
monitor LFTs every 3 months
What are interferons used to treat?
RRMS