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PHM701 > Exam 2 - Multiple Sclerosis > Flashcards

Exam 2 - Multiple Sclerosis Flashcards

1
Q

What is thought to play a role in MS development? (2)

A

latitude and vitamin D

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2
Q

Explain clinically isolated syndrome (CIS)?

A

used to describe the first episode of MS neurologic symptoms lasting at least 24 hrs

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3
Q

What is the most common form of MS?

A

RRMS

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4
Q

What are treatments for acute exacerbation of MS? (3)

A

corticosteroids (methylprednisolone followed by prednisone), H2/PPI, monitor BG

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5
Q

What is the MOA of interferon betas?

A

suppress T-cell proliferation

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6
Q

Which medications are interferon beta-1as? (3)

A

Avonex, Rebif, Plegridy

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7
Q

What is the dosing and ROA for Avonex?

A

30 mcg IM qw

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8
Q

What is the dosing and ROA for Rebif?

A

22 or 44 mcg SQ tiw

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9
Q

What is the dosing and ROA for Plegridy?

A

complicated SQ eow

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10
Q

Which medications are interferon beta-1bs? (2)

A

Betaseron, Extavia

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11
Q

What is the dosing and ROA for interferon-1bs (Betaseron and Extavia)?

A

250 mg SQ qod

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12
Q

What are AEs for interferon betas? (2)

A

flu-like symptoms, injection site reactions

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13
Q

What is the MOA of glatiramer acetate?

A

alteration of T-cell activation and differentiation

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14
Q

Which medications are glatiramer acetate? (2)

A

Copaxone, Glatopa

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15
Q

What is the dosing and ROA for glatiramer acetate (Copaxone and Glatopa)?

A

20 mg qd or 30 mg tiw

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16
Q

What are AEs for glatiramer acetate? (2)

A

injection site reactions, heart attack symptoms

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17
Q

What is the MOA of natalizumab (Tysabri)?

A

antagonizes alpha-4 integrin of the adhesion molecule very-late activating antigen on leukocytes

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18
Q

What is the dosing and ROA for natalizumab (Tysabri)?

A

300 mg IV qiw (4 weeks)

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19
Q

What is a BBW of natalizumab (TysabrI)?

A

progressive multifocal leukoencaphalopathy (PML)

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20
Q

What is the MOA of alemtuzumab (Lemtrada)?

A

targets CD52 causing reduction of circulating T-cells

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21
Q

What are important counseling points for alemtuzumab (Lemtrada)?

A

must have already failed two or more medications for MS

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22
Q

What are AEs of alemtuzumab (Lemtrada)? (4)

A

thyroid disorders, infusion reactions, rash, dusgeusia

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23
Q

What is the MOA of ocrelizumab (Ocrevus)?

A

targets CD20 causing reduction of circulating B-cells

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24
Q

What is ocrelizumab (Ocrevus) also indicated for?

A

PPMS

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25
What are AEs of ocrelizumab (Ocrevys)? (2)
infusion reactions, infection susceptibility
26
What are contraindications for ocrelizumab (Ocrevys)?
active HBV infection
27
What is the MOA of ofatunumab (Kesimpta)?
targets CD20 causing reduction of circulating B-cells
28
What are AEs for ofatunumab (Kesimpta)? (2)
infection susceptibility, HA
29
What is the MOA of mitoxantrone?
intercalates with DNA and inhibits topoisomerase II
30
What is mitoxantrone also indicated for?
PRMS
31
What is the dosing and ROA for mitoxantrone?
12 mg/m^2 IV q3 months
32
What are AEs for mitoxantrone? (2)
cardiotoxicity, bone marrow suppression
33
What is the indication for cladribine (Mavenclad)?
RRMS and SPMS but NOT CIS
34
What is the MOA of cladribine (Mavenclad)?
nucleoside analogue; cytotoxic effects on B and T lymphocytes
35
What is the dosing and ROA for cladribine (Mavenclad)?
10 mg PO for two years
36
What are contraindications for cladribine (Mavenclad)? (2)
pregnancy, current malignancy
37
What are AEs for cladribine (Mavenclad)? (2)
HA, infection
38
What is the MOA of fingolimod (Gilenya)?
S1P receptors; depletes T lymphocytes
39
What is the indication for fingolimod (Gilenya)?
RRMS, SPMS and CIS
40
What is needed prior to initiating fingolimod (Gilenya)? (3)
ECG, bloodwork, and eye exam
41
What are contraindications for fingolimod (Gilenya)?
heart problems
42
What is the MOA of siponimod (Mayzent)?
S1P receptors; blocks lymphocytes emigration from lymph nodes
43
What is the indication for siponimod (Mayzent)?
RRMS, SPMS and CIS
44
What is the genotype that is contraindicated for siponimod (Mayzent) use?
CYP2C9*3/*3
45
What is the genotype that requires dose adjustment for siponimod (Mayzent) use? (2)
CYP2C9*1/*3 and *2/*3
46
What are AEs of siponimod (Mayzent)? (3)
infections (PML), macular edema, heart issues (QTc prolongation, bradycardia)
47
What is the MOA of ozonimod (Zeposia)?
S1P receptors; blocks lymphocytes emigration from lymph nodes
48
What are contraindications for ozonimod (Zeposia)?
heart issues
49
What are AEs of ozonimod (Zeposia)?
infection
50
What is the MOA of teriflunomide (Aubagio)? (2)
blocks pyrimidine synthesis, decreases the ability of antigen-presenting cells to active T-cells
51
What is the indication for teriflunomide (Aubagio)?
RRMS and SPMS
52
What are AEs of teriflunomide (Aubagio)? (3)
infection, alopecia, paresthesias
53
What are BBWs for teriflunomide (Aubagio)? (2)
hepatoroxicity, teratogenicity
54
What are DDIs for teriflunomide (Aubagio)? (3)
contraceptives, statins, warfarin
55
What is the MOA of dimethyl fumarate (Tecfidera)?
induces cytokines to cause apoptosis in T cells
56
What is the indication for dimethyl fumarate (Tecfidera)?
RRMS, SPMS, and CIS
57
What is the dosing and ROA for dimethyl fumarate (Tecfidera)?
240 mg PO bid
58
What are AEs of dimethyl fumarate (Tecfidera)?
GI
59
What is the benefit of diroximel fumarate (Vulmerity) over dimethyl fumarate (Tecfidera)?
Less GI symptoms
60
What is the benefit of monomethyl fumarate (Bafiertam) over dimethyl fumarate (Tecfidera)?
Less GI symptoms
61
What medications can be used to treat symptoms of MS? (7)
baclofen, dantrolene, BZDRAs, tizanidine, gabapentin, Botox, dalfampridine
62
What medication can be used to treat pseudobulbar affect?
quinidine

PHM701 (14 decks)

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