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PHRM 845 > MS Drugs > Flashcards

MS Drugs Flashcards

1
Q

interferons act where

A

periphery and BBB

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2
Q

interferon MOA

A

inhibit T cells, dendritic cells
inhibit BBB penetration by decreasing MMP
efficacy reduced by neutralizing antibodies

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3
Q

glatiramer acetate acts where

A

periphery

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4
Q

glatiramer acetate MOA

A

decreased T cell activation through dendritic cell modulation

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5
Q

fingolomod acts where

A

periphery and CNS

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6
Q

fingolomod MOA

A

S1P receptor agonist
stimulates oligodendrocyte survival / remyelination in CNS
blocks movement of T cells out of lymph nodes

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7
Q

what is PML

A

progressive multifocal leukoencephalopathy
potentially lethal brain infection

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8
Q

drugs with increased risk of PML

A

fingolomod
natalizumab
fumarates

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9
Q

natalizumab acts where

A

periphery and BBB

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10
Q

natalizumab MOA

A

MAB specific for alpha 4 integrin
inhibits VLA-4 binding and interferes with B and T cell movement into CNS
- effects could be limited by neutralizing antibodies

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11
Q

mitoxantrone acts where

A

periphery

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12
Q

mitoxantron MOA

A

cytotoxic effect
reduces the number of lymphocytes

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13
Q

teriflunomide acts where

A

periphery

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14
Q

teriflunomide MOA

A

cytotoxic effect
inhibits proliferation of lymphocytes (B and T cells)

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15
Q

dimethyl fumarate
diroximel fumarate
monomethyl fumarate
act where

A

periphery and CNS

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16
Q

fumarates MOA

A

metabolized by esterases
suppress activated T cells
promote remyelination
activate Nrf2 mediated antioxidant response and antiinflammatory pathways

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17
Q

siponimod, ozanimod, ponesimod location

A

periphery and CNS

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18
Q

siponimod, ozanimod, ponesimod MOA

A

S1P agonists
oligodendrocyte survival, remyelination
interfere with lymphocyte movement out of lymphoid organs

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19
Q

cladribine location

A

periphery

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20
Q

cladribine MOA

A

cytotoxic effect , results in lymphocyte depletion

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21
Q

rituximab (Ocrelizumab) location

A

periphery

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22
Q

rituximab MOA

A

targets CD20, a B cell marker
- limited by neutralizing antibodies

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23
Q

rituximab (Ocrelizumab) treats

A

decreased relapse rate in RRMS and PPMS some effectiveness in decreased disease progression

24
Q

ATL1102 is an _____targeting ____

A

antisense oligonucleotide targeting VLA4
(same outcome natalizumab)

25
Q

ATL1102 acts at

A

blood brain barrier

26
Q

drugs that effectiveness could be limited by neutralizing antibodies

A

interferon B, natalizumab, rituximab (ocrelizumab)

27
Q

drugs acting via cytotoxic

A

mitoxantrone
teriflunomide
cladribine

28
Q

drugs acting at BBB

A

interferon
natalizumab
ATL1102

29
Q

drugs acting in periphery and CNS

A

fingolamide, other mods
fumarates

30
Q

treatment of acute attacks inpatient

A

methylprednisolone 500-1000 mg IV for 3-7 days +/- oral taper over 1-3 weeks

31
Q

treatment of acute attacks outpatient

A

prednisone 1250 mg PO every other day x 5 doses with no taper

32
Q

oral meds

A

fumarates, fingolomods, teriflunomide

33
Q

injectible meds

A

interferons, glatiramer acetate

34
Q

infusion meds

A

almetuzumab, natalizumab, ocrelizumab

35
Q

patients must be tested for what to check for risk of PML?

A

JCV antibodies

36
Q

which kind of vaccines are preferred in MS

A

inactivated

37
Q

which drug can you not take with live vaccine

A

almetuzumab

38
Q

____ vaccine should be considered in pts who have never had

A

varicella, chicken pox

39
Q

fumarates pearls and monitoring

A

do not open capsule
monitor LFTs
PML risk
flushing, take with ASA 30 mins before

40
Q

SP1 agonist are contraindicated in what

A

pts with arrythmia hx or heart condition

41
Q

discontinuation of what agent can worsen sx

A

SP1 agonists , mods

42
Q

which drug to avoid with MAO inhibitor

A

ozanimod

43
Q

which drug requires CYP2C9 testing?

A

siponimod

44
Q

glatiramer acetate pearls

A

rotate injection site - lipoatrophy
flu like symptoms or chest pain
maybe good for pregnancy

45
Q

interferons dosing

A

subq or IM every other day to every 2 weeks

46
Q

interferons side effects

A

flu like symptpms - take acetaminophen or NSAID before
depression / suicide

47
Q

interferons monitoring

A

LFT and TSH

48
Q

which drug contraindicated in HIV

A

almetuzumab

49
Q

which drug contrainidcated in Hep B

A

ocrelizumab

50
Q

drug approved for PPMS

A

ocrelizumab

51
Q

which drug contraindicated in pregnancy

A

teriflunomide

52
Q

what to give if pregnant on teriflunomide

A

charcoal for 11 days or cholestryamine

53
Q

drugs with pregnancy concerns

A

mitroxantrone, cladribine, SP1s, ocrelizumabw

54
Q

which drug can improve walking speed

A

dalfampridine

55
Q

IR dosing of dalfampridine can cause what

A

seizures

PHRM 845 (32 decks)

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