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Review of Pharmacology - 9E (2015)

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<strong>Review</strong> <strong>of</strong> <strong>Pharmacology</strong><br />

Contd...<br />

3. Natalizumab<br />

(Monoclonal<br />

antibody against<br />

α4 subunit <strong>of</strong><br />

α4b1<br />

integrin on<br />

lymphocytes)<br />

• Prevents<br />

lymphocytes<br />

from binding to<br />

endothelial cells,<br />

thus inhibits<br />

transfer across<br />

BBB and entry in<br />

CNS<br />

4. Fingolimod • Traps lymphocytes<br />

in spleen and<br />

lymph nodes by<br />

preventing their<br />

egress<br />

• Thus, entry in CNS<br />

decreases<br />

i.v.<br />

infusion<br />

Once a<br />

month<br />

• Progressive multifocal<br />

leucoencephalopathy if<br />

used for >2years<br />

Oral Once a day • Altered LFT<br />

• First degree heart<br />

block<br />

• Bradycardia<br />

5. Mitoxantrone<br />

(Anthracycline<br />

anticancer drug)<br />

• Topoisomerase II<br />

inhibition<br />

i.v. Once in 3<br />

months<br />

• Cardiotoxicity<br />

• Acute leukemia<br />

6. Dimethyl<br />

fumarate<br />

(approved in<br />

UK, not in USA)<br />

• Promotes antiinflammatory<br />

and inhibit<br />

pro-inflammatory<br />

cytokines<br />

Oral Twice a day Progressive multifocal<br />

leucoencephalopathy<br />

Central Nervous System<br />

7. Teriflunomide<br />

(Active<br />

metabolite <strong>of</strong><br />

leflunomide)<br />

8. Cladribine<br />

(Purine analog<br />

anticancer drug)<br />

9. Dalfampridine<br />

(4-Aminopyridine)<br />

• Dihydroorotate<br />

dehydrogenase<br />

inhibitor<br />

• Inhibit DNA<br />

synthesis and<br />

repair<br />

• K + Channel<br />

blocker to improve<br />

weakness in MS<br />

Oral Once a day Hepatotoxicity<br />

Oral Used for 2<br />

weeks every<br />

year<br />

Oral Once a day • Seizures<br />

Immunosuppression<br />

• Secondary neoplasms<br />

• Herpes zoster<br />

320<br />

https://kat.cr/user/Blink99/

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