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18 Cards in this Set
- Front
- Back
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List 5 typical drugs used in TX of MS
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Steroids
Interferons alfa and beta Natalizumab Glatiramer Mitoxantrone |
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How does Natalizumab work?
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it is a humanize antibody directed against cellular adhesion protein alfa 4. In other words, we reduce T cell ability to migrate into the brain and produce demyelination.
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How does Glatiramer work?
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Not fully understood but:
Structurally resembles MBP, so may serve as a decoy for T cells. Redirects T cell diff-n to T regs vs Th1s, so more immunosuppressive vs inflammatory |
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How does Mitoxantrone work?
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Used only in advanced MS
toxic, a cancer drug inhibits topoisomerase II, so no DNA synthesis and repair |
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Glatiramer side efffects
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Flushing and SOB at injection
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Most common SE of interferons?
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Liver damage
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What drug appears to slow worsening of MS?
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Interferon
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Risk of what fatal neurological condition does Natalizumab increase in MS?
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PML, usually fatal
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What is the major SE of mitoxantrone?
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cardiotoxicity
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What is memantine? And what is the major SE of side effect?
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NMDA antagonist used in Alzheimer's
high dose may cause psychosis |
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List 3 drugs commonly used in tx of Alzheimer's
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Galantamine
Donepezil Rivastigmine (AchE inhibitors) |
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What antidepressant should we use in Alzheimer's? Which should we not use?
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Use sertraline
Do not use TCAs, since they are anticholinergic |
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So what's up with hippocampus in Alzheimer's
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it's basically deafferentiated
loss of DA and NE input |
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What should you use and not use in Alzheimer's pts for anxiety
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use buspirone
do not use benzos in pts with dementia, ever |
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FUll doses of 2nd generation antipsychotic drugs in Alzh pts increase mortality from what?
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cardiac mortality
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What two drugs should we use in pts with Tourette's
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halperidol and primozide
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What drugs should we use in Huntington's
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tetrabenazine
haloperidol |
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MOA of tetrabenazine
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used in Huntington's
depletes NE, DA, 5HT (first increases 5HT so gives nausea and vomiting) |
