Multiple sclerosis

Question 1

MS - 8 drugs

Answer 1

Interferon beta-1b
Interferon beta-1a (natalizumab)
Mitozantrone
Glatiramer acetate 
Dalfampridine
Fingolimod
Steroids
Baclofen

Question 2

Interferon beta-1b - MOA

Answer 2

Increases cytotoxicity of NK cells and increases the phagocytic activity of macrophages.
Reduces the amount of interferon-γ secreted by activated lymphocytes

Question 3

Interferon beta-1b - adverse effects

Answer 3

Chills, diarrhea, fever, headache, hypertension, myalgia, pain, vomiting

Question 4

Interferon beta-1b - interactions

Answer 4

Increases serum levels of zidovudine

Question 5

Interferon beta-1a - MOA

Answer 5

Blocks the molecular pathway involving cell adhesion that draws lymphocytes into the CNS

Question 6

Natalizumab - indications

Answer 6

Relapsing forms of MS

Question 7

Mitoxantrone - MOA

Answer 7

Antineoplastic agent.

Suppress T cells, B cells and macrophages that attack myelin sheath

Question 8

Glatiramer acetate - MOA

Answer 8

Synthetic protein that mimics myelin protein structure. Block myelin-damaging T cells by acting as myelin decoy.

Question 9

Dalfampridine - MOA

Answer 9

Block potassium channels and enhances conduction in damaged nerves

Question 10

Fingolimod - MOA

Answer 10

Block egress of lymphocytes from lymph nodes, reducing the number of lymphocytes in peripheral blood.

Question 11

Fingolimod - indications

Answer 11

Relapsing form of MS

Question 12

Steroids - indications in MS

Answer 12

Acute exacerbations

Question 13

Which steroid is often used in MS exacerbations?

Answer 13

Prednisone (oral for mild cases, and parenterally in high doses for severe cases)

Question 14

Steroids - adverse effects (MS)

Answer 14

Aggravation of DM, GI bleeding, mood changes, pancreatitis, seizures.

Question 15

Steroids - interactions (MS)

Answer 15

Barbiturates, carbamazepine, phenytoin and rifampin decrease serum levels