Autoimmune Dx - Multiple Sclerosis (MS) Flashcards Preview

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Flashcards in Autoimmune Dx - Multiple Sclerosis (MS) Deck (37):
0

What's multiple sclerosis (MS)?

Chronic, progressive autoimmune dx in which the pts immune system attacks the myelin peptide antigens, destroying the fatty myelin sheaths that surround the axons in the brain and spinal cord (CNS)

1

How do pts experience MS?

Periods of dx activity ff by intervals of remission

2

Primary goal of MS therapy?

Prevention of dx progression; whats lost in neuronal fxn can't be regained

3

Which chemo therapeutic agent is sometimes used for MS and is FDA approved?

Mitoxantrone

4

Which chemo therapeutic agent is sometimes used for MS and is not FDA approved?

Cyclophosphamide

Azathioprine

IV immunoglobulin

Alemtuzumab

5

What's the brand name of Glatiramer acetate?

Copaxone

6

MOA of Glatiramer acetate (Copaxone)?

Immune modulator, mech not well-defined

7

SE of Glatiramer acetate (Copaxone)?

Injection site rxns (inflammation, erythema, pain, pruritus, mass)

Infection

Pain

Flushing

Diaphoresis

Chest pain

Weakness

Anxiety

Rash

Nausea

8

Howz Interferon beta-1a (Avonex) used?

IM 30mcg weekly

9

Howz Interferon beta-1a (Rebif) used?

SC 22mcg or 44mcg three times per week

10

Howz Interferon beta-1b (Betaseton, Extavia) used?

SC: 0.25mg Every other day

11

SE of interferon beta?

Injection site rxns

12

Which interferon are used SC?

Rebif and Betaseron/Extavia

13

How do u inject Rebif or Betaseron/Extavia?

SC injections

Pinch skin, inject into SC tissue in abdomen, left and right arm, thighs, buttocks, rotate sites

14

Should small air bubble in pre-filled syringes be expelled? Why or why not?

No, small air bubbles shouldn't be expelled.

Bcuz dose may be reduced

15

What's Natalizumab?

Recombinant humanized monoclonal antibody

16

Brand name of Natalizumab?

Tysabri

17

How's Natalizumab (Tysabri) used?

300mg IV given over 1hr, Q4WEEKS

18

What's the black box warning of Natalizumab (Tysabri)?

Can cause progressive multifocal leukoencephalopathy (PML)

19

List oral immune modulator agents

Fingolimod (Gilenya)

Teriflunomide (Aubagio)

Dimethyl fumarate (Tecfidera)

20

What's warning associated with Fingolimod (Glienya)?

Decrease in heart rate (must monitor)

21

Monitoring parameters for Fingolimod (Gilenya)?

CBC (baseline and periodically thereafter)

ECG (baseline; repeat after initial dose observation period)

22

Why's ECG monitoring important for Fingolimod (Gilenya)?

Postdose symptomatic bradycardia can occur

23

Howz Dimethyl fumarate (Tecfidera) not to be used?

Don't crush, chew or sprinkle content on food

24

MOA of Dalfampridine (Ampyra)?

Potassium channel blocker, may increase nerve signal conduction

25

What changes may happen to the body temp when on interferons (Avonex; Rebif; Betaseron/ Extavia)?

Signs of infection such as fever if 100.5F (38C) or higher, chills, very bad sore throat, cough, sputum, or change in color of sputum, sweating or pain

26

What sx control agent is used for incontinence in MS?

Anticholinergic

27

What sx control agent is used for constipation in MS?

Laxatives

28

What sx control agent is used for diarrhea in MS?

Loperamide

29

What sx control agent is used for muscle spasms/spasticity in MS?

Skeletal muscle relaxants

30

What sx control agent is used for localized pain and spasms in MS?

Botulinum toxin (Botox) can be used to relief pain for up to 3 months

31

What sx control agent is used for tremor in MS?

Propranolol

32

What sx control agent is used for depression in MS?

Antidepressants

SNRI if chosen can work for both neuropathic pain and depression

33

What sx control agent is used for fatigue in MS?

Modafinil or stimulants used in ADHD such as methylphenidate

34

What sx control agent is used for dizziness and vertigo in MS?

Meclizine and Scopolamine

35

What sx control agent is used for cognitive fxn in MS?

Acetylcholinesterase inhibitors, including Donepezil

36

What sx control agent is used for erectile dysfunction in MS?

Can be treated with phophodiesterase inhibitors

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