Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Multiple Sclerosis > MS treatment > Flashcards

MS treatment Flashcards

(58 cards)

Start Studying
1
Q

Brand name of daclizumab

A

Zinbryra

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Brand name of Glatiramer Acetate

A

Copaxone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Brand name of Inf b-1a

A

Avenox and Rebif

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Brand name of Inf b-1b

A

Betaseron and Extavia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Brand name of pegylated Inf b-1a

A

Plegridy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Brand name of Dimethyl fumarate

A

Tecfidera

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Brand name of Fingolimod

A

Gilenya

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Brand name of Teriflunomide

A

Aubagio

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Brand name of Alemtuzumab

A

Lemtrada

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Brand name of Mitoxantrone

A

Novantrone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Brand name of Natalixumab?

A

Tysabri

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Brand name of Ocrelizumab

A

Ocrevus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are Tier 1 medications?

A

Interferon beta 1-b, interferion beta-1a, pegylated Inf b-1a, and Copaxone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Indications for Tier 1 medications?

A

typically considered 1st line therapy for new diagnosis of MS. If patient has severe disease burden, contraindications to the injectables, severe recurrent relapses in a short period, then can start with Tier 2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Mechanism of action of daclizumab/Zinbrya?

A

modulation of IL-2 mediated activation of lymphocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Common Adverse effects of Zinbrya?

A

URI, pharyngitis, increased ALT, UTI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Labs to follow for Zinbrya and how often?

A

get baseline ALT/AST/Tbili and check Q mo up to 6 mo after last dose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Mechanism of action of the Inf b-1b and 1a?

A

anti-inflam: down regulates cytokines, MHC Ags, decrease transmigration of T lymphocytes across the BBB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Side effects of Inf b-1b and 1a?

A

flu-like sx, leukopenia, elevated liver enzymes, thyroid dysfunction, injection site reaction, depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Labs to follow for Inf b-1b and 1a?

A

CBC, LFT q 3 mos during frst yr and then q6mos thereafter; TSH q3-6 mos during 1st year and yearly thereafter, monitor mood changes, site rotation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Mechanism of action of Demethyl fumarate/Tecfidera?

A

unknown; activates Nrf2 pathway (involved in cellular response to oxidative stress)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Common side effects of Tecfidera?

A

flushing, abdominal pain, nausea, diarrhea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Warnings of Tecfidera?

A

lymphopenia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Labs to monitor for Tecfidera?

Study These Flashcards
A

CBC < 6 mo before starting txt and annually

25
Mechanism of action of Fingolimod/Gilenya?
binds to immune cells and sequesters them in lymph nodes, reducing availability for cell mediated immune response -fingolimod crosses BBB --\> phosphorylated to form fingolimod-phosphate --\> binds to S1P receptors and down regulation of S1P receptors --\> reduces release of lymphocytes
26
Major possible side effects of Gilenya?
bradycardia after 1st dose, infxn, macular edema, decreased PFTs, liver injury, HTN and increase risk of herpes zoster
27
What do you need to monitor with Gilenya?
screen: WBC, AST/ALT,bili, serum varicella zoster ab testing (in pts withno hx of chicken pox), baseline EKG, ophthalmologic evaluation. Observe brady x 6hrs after 1st dose, ophtho eval after 3-4 mo of txt, PFT if indicated, use contraception during txt and for 2 mo after stopping txt
28
Efficacy of Gilenya?
it is more effective than injectables; less effective than Tysabri. A good alternative to Tysabri. Per Dr. Eicher, 54% efficacy.
29
Contraindications to starting Gilenya? (5)
preexisting or recent heart conditions, baseline QTc \> 500ms, txt with class Ia or class III antiarrhythmic drugs, TIA, stroke
30
Efficacy of Tecfidera?
per Dr. Eicher, it has a high fail rate in patients with strong MS
31
Mechanism of Aubagio
inhibits DNA synthesis in rapidly dividing cells such as lymphocytes. Alternate salvage pathway allows pyrimidine synthesis to continue at reduced rate in resting cells
32
common side effects of Aubagio?
abnormal liver function, alopecia, diarrhea, influenza, nausea, paresthesias
33
Black box warnings of aubagio?
black box: elevated LFTs and fetal death/malformations; skin rxn, BP increase, respiratory effects
34
Pre-txt evaluation for Aubagio? What do you monitor during txt?
pre-txt: eval for infxn, pregnancy, RF, peripheral neuropathy, interstitual pulm disease, HTN, WBC, AST/ALT/tbili. During txt: BP monitoring and AST/ALT
35
What are Tier 3 medications?
Lemtrada, Novantrone, Tysabri, Ocrevus
36
Indications for Lemtrada?
pts who have had inadequate response to 2+ therapies
37
Mechanism of Lemtrada?
binds CD52 (cell surface Ag on T and B lymphocytes, nKC, macrophages) --\> ab-dependent cytolysis and complement mediated lysis
38
Possible side effects of Lemtrada?
infusion rxn in 92% of pts during infusion and up to 24 hours after (3% are severe such as analhylactic shock, angioedema, bronchospasm, hypotension). serious autoimmune condition such as thrombocytopenia and increase risk of malignancy
39
What to monitor before and during treatment with Lemtrada?
premedicate with corticosteroids prior to 1st three infusions, antiviral agents for herpetic ppx for 2 months or until CD4 count is \> 200, check TSH Q3mo and CBC Q month, until 48 mo after last infusion, avoid during active infxn, avoid live viral vaccines
40
Indications for Novantrone?
SPMS, PRMS, worsening RRMS
41
Mechanism of action of Novantrone?
inhibits DNA synthesis, reduces lymphocytes, reduces Th1 cytokines
42
Common side effects of Novantrone?
blue-green urine 24 hours after administration, infections, bone marrow suppression, nausea, hair thinning, bladder infections, mouth sores
43
Major side effect of Novantrone?
dose dependent cardiac toxicity, AML (esp with cumulative doses \> 60mg/m2)
44
What to monitor while on Novantrone?
baseline LVEF prior to each dose and after txt completed
45
Mechanism of Tysabri?
binds to alpha4/beta 1 integrin on activated lymphocytes and monocytes; inhibits leukocyte migration across the BBB
46
Major side effects of Tysabri?
PML, hepatotoxicity including acute liver failure, encephalitis/meningitis with HSV and VZV
47
What is the general risk of PML when on Tysabri?
1 in 1000
48
What are risk factors that increase risk of PML in Tysabri recipients to 11 in 1000?
JC ab+, prior txt with immunosuppressant, \> 2 years on Tysabri
49
What to monitor while on Tysabri?
ab testing should be repeated Q6mo with monitoring 6 mo after end of txt
50
Indications for Ocrevus?
RRMS, PPMS
51
Mechanism of Ocrevus?
binds CD20, cell surface antigen on pre-B and mature B lymphocytes, causing antibody-dependent and complement-mediated cytolysis
52
Potential side effects of Ocrevus?
Respiratory tract infxns, herpes, potentially PML, hepatitis B reactivation, possible increased immunosuppressive effect, increase risk of malignancy
53
What to do prior to treatment with Ocrevus?
premedicate with corticosteroids and antihistamine and observe 1hr after infusion, administer all vaccines 6 weeks prior to Ocrevus, no live attenuated or live vaccines during txt until B cell repletion, breast cancer screening protocol
54
txt of fatigue?
Modafinil, SSRI
55
txt of spasticity?
OT/PT, baclofen, tizanidine
56
txt of paroxysmal symptoms and pain
carbamazepine, phenytoin, gabapentin, TCAs, Botox
57
txt of depression?
SSRI, TCAs,
58
txt of cerebellar tremor?
Clonazepam, Valproic acid, Isoniazid, thalamic stimulator

Multiple Sclerosis (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions