Term
| Which immune cells are involved in the cause of MS? |
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Definition
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Term
| Describe the pathophysiology of MS? |
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Definition
1. Demyelination
2. Formation of plaques around nerves, damages axons
3. Disruption of nerve signals
4. Many plaques form at the same time, cause multiple unrelated neurologica dysfunction. |
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Term
| What are the primary symptoms of MS? |
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Definition
Visual complaints Cognitive changes
Gait problems Bowel/bladder
Paresthesis Sexual dysfunct.
Spasticity Tremor
Weakness
Speech difficulty |
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Term
| What are secondary symptoms of MS? |
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Definition
complications from primary symptoms
Recurrent UTI
Urinary calculi
Pressure ulcers
Muscle contractures
Respiratory infections
Poor nutrition |
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Term
| What are tertiary symptoms of MS? |
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Definition
MS effect on everyday life:
Personal and social problems
Emotional problems
Vocaitonal problems |
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Term
| What may MS acute attacks be aggravated by? |
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Definition
Infections Exertion
Lack of sleep Child birth
Hyperventilation
Stress
Malnutrition
Anaemia
Organ dysfunction |
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Term
| What are the Five types of MS? |
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Definition
1. Relapsing-Remitting MS
2. Secondary Progressive MS
3. Primary Progressive MS
4. Relapsing Progressive MS
5. Benign MS |
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Term
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Definition
Clinical evaluation - neurological signs
Macdonalds criteria
MRI
CSF analysis
VEP: visual evoked potentials
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Term
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Definition
Visual evoked potentials:
measures time taken to respond to stimulation and the size of the response - visual response measured |
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Term
| What are three modes of MS therapy? |
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Definition
1. Symptomatic management
2. Treatment of acute attacks
3. Disease modifying therapy |
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Term
| What the goals of immunotherapy in the treatment of MS? |
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Definition
1. Decrease frequency and severity of acute attacks.
2. Diminish progression of lesions
3. Slow progression of disability |
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Term
| How are acute attacks of MS treated? |
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Definition
Mild attacks/no func. decline not treated. --> Rest.
DD - infection, pain, depression
Moderate: Predinsolone 75mg for 4 days tapering down.
Severe: IV cort. (Methylprednisolone) |
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Term
| What are MS acute attacks differentiate diagnosed against? |
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Definition
infection
depression
fever |
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Term
| What are the 1st line MS disease-modyfying therapies? |
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Definition
Immunomodulators
Interferon-B-1b (Betaferon)
Interferon-B-1a (Avonex, Rebif)
Copaxone - synthetic polypeptide
Natalizumab (Tysabri)
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Term
| What is 2nd line therapy for MS disease modifying? |
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Definition
Methotrexate
Azathioprine
Mitozantrone and Mitoxantrone |
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Term
| In what type of MS are immunosupressants employed as 1st line therapy? |
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Definition
Primary progressive
Secondary progressive |
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Term
| What is Betaferon and its MOA? |
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Definition
synthetic analogue of E.coli recombinant interferon-B
- augments suppressor cell function
- reduce interferon-gamma secretion
- suppress T cell proliferation and BBB permeability |
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Term
| What are the interferon-B-1a drugs? |
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Definition
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Term
| What are the side effects of avonex and rebif? |
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Definition
injection site redness, swelling, flu-like symptoms - fever, chills, myalgias
Less common: tachycardia, SOB, depression
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Term
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Definition
Synthetic polypeptide composed of alanine, glutamic acid, lysine, and tyrosine as in basic myelin proteins
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Term
| What is the dose and how is Copaxone administered? |
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Definition
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Term
| What are the side effects of Copaxone? |
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Definition
| Mild side effects: mild pain, pruritis at injection site, transient reaction of chest tightness, flushing and dyspnea |
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Term
| What is the MOA of natalizumab (Tysabri)? |
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Definition
| selectively inhibits adhesion molecules slowing the entry of T-cells into the brain |
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Term
| How is natalizumab (Tysabri) given? |
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Definition
| monthly infusion - 300mg over 1hr. |
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Term
| What is side effect of natalizumab (Tysabri) monitored for after injection? |
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Definition
Fatigue - monitor 2hr after infusion.
Also, risk of progressive multifocal leukoencephalopathy. |
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Term
| What drug is used to treat the symptoms of fatigue in MS? |
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Definition
| Amantadine - 100-200mg daily |
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Term
| What drugs are used to treat the spasticity, dystonias, and tremors of MS? |
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Definition
Baclofen
Clozepam
CBZ
Diazepam |
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Term
| What drugs may be used to regulate bladder function in MS patients? |
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Definition
Oxybutinin
Amitryptiline
Imipramine
Propantheline |
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Term
| What drug may be used to treat sexual dysfunction in men with MS? |
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Definition
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