Immunosuppressives I didn't learn yet

Question 1

What are the immunosuppressive drugs used in relapsing remitting MS?

Answer 1

Fingolimod
Natalizumab
Interferon Beta
Glatiramer acetate

Question 2

Fingolimod

MOA

Answer 2

Analog of sphingosine
Binds sphingosine 1 phosphate receptor on lymphocytes
Antagonizes lymphocyte response and sequesters them in the lymph node (prevents them from accessing the CNS in MS patients)

Question 3

Fingolimod

Adverse Effects

Answer 3

Bradyarrhythmia
AV block

Increased risk varicella zoster virus infection

Increased risk malignancy

Question 4

Natalizumab

MOA

Answer 4

Anti-alpha-4-integrin antibody that blocks entry of lymphocytes into CNS

Question 5

Natalizumab

Adverse Effects

Answer 5

Increased risk of PML, esp if seropositive for JC virus or has used immunosuppressive drugs before

Question 6

Interferon Beta

MOA

Answer 6

Reduce entry of inflammatory cells into the CNS and reduces T cell activation

Question 7

Glatiramer Acetate

MOA

Answer 7

Mixture of 4 AAs found in myelin basic protein

Promotes production of suppressor T cells that migrate to brain and produce suppression at sites of inflammation