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Pharmacology II > Immunopharmacology - Multiple Sclerosis > Flashcards

Immunopharmacology - Multiple Sclerosis Flashcards

1
Q

Environmental factors of MS? (6)

A 
Far from equator
Decreased sun
Decreased vitamin D
Microbes
Least common in rural
Migration
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2
Q

2 important factors of MS?

A

Environmental

Genetic

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3
Q

Causes of MS? (3)

A

Higher number of immune cells (virus/genetic defect)
Environment
Heredity

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4
Q

Which virus is involved in MS? It infects which cells?

A

EBV : Esptein-Barr virus

B cells

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5
Q

4 mechanisms that EBV infects B cells?

A
  1. Molecular mimicry
  2. B cell transformation through LMP1 and LMP2A
  3. B cell trafficking to CNS
  4. Unknown mechanisms
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6
Q

What is MS?
It results in a progressive decline in ______ and _____ function
What is the target of the immune response?

A

Autoimmune disease where the immune system attacks myelin
Motor and cognitive function
Myelin basic protein

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7
Q

What is the pathological hallmark in MS?

It contains what? (2)

A

Lesions (disseminated white matter lesions of the CNS)

  1. Perivascular inflammation
  2. Demyelination
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8
Q

Where are demyelinating plaques mostly found in the CNS? Most frequently affected sites are… (4)

A

Anywhere within white matter

  1. Optic nerves
  2. Brainstem
  3. Cerebellum
  4. Spinal cord
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9
Q

How does axonal injury occur?

A

Repeated cycles of demyelination and remyelination

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10
Q

Explain autoimmune-mediated demyelination

A

Acute inflammatory response of auto-reactive lymphocytes (T cells) and macrophages produce demyelination by the release of pro-inflammatory factors that damage oligodendrocytes and axons

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11
Q

4 subtypes of MS?

A

Benign
Relapsing-remitting
Primary progressive
Secondary chronic progressive

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12
Q

7 signs/symptoms of MS?

A 
Vision impairment
Tingling and numbness of the skin and limbs
Weakness and exhaustion
Difficulty with walking
Memory loss
Depression
Urinary and bowel problems
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13
Q

4 treatments of relapsing-remitting MS?

A

Interferon-beta
Glatiramer acetate
Tysabri
Dimethyl Fumarate

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14
Q

2 treatments of secondary progressive MS?

A

Interferon-Beta

Mitoxantrone

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15
Q

Treatment of primary progressive MS?

A

none

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16
Q

Treatment of acute relapses of MS?

A

Corticosteroids

17
Q

MOA of glucocorticoids?

A

Inhibition of the expression of pro-inflammatory genes

18
Q

How is Interferon-Beta administered?

MOA?

A

Subcutaneous injection

Unclear MOA: reduces inflammation, perhaps promotes apoptotic elimination of auto-reactive immune cells

19
Q

Glatiramer acetate is found where?

It works as a _____ for the immune system

A

in myelin basic protein

decoy

20
Q

Administration of glatiramer does what?

A

shifts population of T cells from pro-inflammatory Th1 cells to regulatory Th2 cells that suppress the inflammatory response

21
Q

What type of drug is mitoxantrone?

It suppresses the proliferation of which cells? (3)

A

Type II topoisomerase inhibitor

T cells, B cells, macrophages

22
Q

Mitoxantrone enhances ______ _______ function and inhibits ________ function and ______ presentation

A

T-cell suppressor function
B-cell function
Antibody presentation

23
Q

Tysabryi is what type of drug against which molecule?

A

Monoclonal Ab against cellular adhesion molecule alpha4-integrin

24
Q

MOA of Tysabryi?

A

Interferes with ability of immune cells to attach to endothelial cells and cross BBB

25
Q

What type of drug is Fampridine-SR? MOA?

A

Selective neuronal K+ channel blocker

Closes exposed potassium channels in damaged nerve fibres, enables axon to transmit nerve impulses again

26
Q

What is the first oral therapeutic approved for the treatment of MS?
Most recent oral therapeutic approved?

A 
Fingolimod (Gilenya)
Dimethyl fumarate (Tecfidera)
27
Q

What type of drug is Fingolimod? MOA?

A

Sphingosine 1-phosphate receptor modulator

Sequesters lymphocytes in lymph nodes, preventing them from contributing to an autoimmune reaction

28
Q

MOA of dimethyl fumarate?

A

Activates Nrf-2, increases expression of mitochondrial and anti-oxidant genes that reduce inflammation and protect oligodendrocytes and neurons

Pharmacology II (21 decks)

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