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NAPLEX 21 > Autoimmune Conditions: MS > Flashcards

Autoimmune Conditions: MS Flashcards

1
Q

MS is a chronic progressive autoimmune disease in which the patient’s immune system attacks the:

A

myelin sheath – the fatty substance that surrounds and insulates nerve fibers of the brain and spinal cord axons

*electrical impulses will dwindle

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2
Q

How do MS patients present in the early stages?

A

fatigue

weakness

tingling

numbness

burred vision

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3
Q

Clinical presentation as MS progresses?

A

deterioration of cognitive function, visual disturbances

muscle spasms

pain

incontinence

gait instability

*worse in males :)

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4
Q

What test is performed to make a diagnosis?

A

MRI, spinal fluid analysis, evoked proteins

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5
Q

What is the primary goal of therapy?

A

prevention of disease progression - medications are used to modify disease, treat relapses and manage symptoms

what is lost in neuronal function cannot be regained

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6
Q

a chemotherapeutic agent approved for MS

A

mitoxantrone

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7
Q

What meds are used to help with relapses?

A

steroids

corticotropin - SC, IM x 2-3 weeks

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8
Q

What parenteral drugs are the mainstay of treatment for patients with relapsing forms of MS

A

interferon beta formulations –> Betaseron, Avonex, Rebif, Extavia, Plegridy

glatiramer acetate –> Copaxone, Glatopa

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9
Q

What is the name of the PEGYLATED interferon beta? how is it dosed?

A

Plegridy

every 14 days

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10
Q

How is medication supplied/dispensed

A

single-dose profiled syringe & needles are provided

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11
Q

Some of the powders reconstituted contain what?

A

albumin

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12
Q

Brand: Copaxone

A

generic: glatiramer acetate

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13
Q

an immune modulator thought to induce and activate t lymphocyte suppressor cells in relapsing forms of MS // MOA not really defined

A

glatiamer acetate

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14
Q

This drug is dosed: SC daily, or SC 3x per week (48 hours between)

Warnings: chest pain

side effects: flushing, diaphoresis, dyspnea

A

glatiamer acetate

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15
Q

What is the drug of choice in pregnancy for MS?

A

glatiamer acetate

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16
Q

this drug alters the expression and response to surface antigens, enhancing immune cell function /// MOA not really defined

A

interferon beta products

17
Q

generic: interferon beta-1a

A

Brand: Avonex, Rebif

18
Q

How is Avonex dosed?

A

IM weekly

19
Q

How is Rebif dosed?

A

SC three times per week/ 48 hours apart

20
Q

generic: interferon beta-1b

A

Brand: Betaseron, Extavia

21
Q

How is Betaseron dosed?

A

every other day

22
Q

Which drug is dosed every 14 days?

A

Plegridy

23
Q

This drug class has warnings for psychiatric disorders, injection site necrosis, increased LFTs, thyroid dysfunction (hypo and hyper)

side effects: flu like symptoms

A

Interferon beta products

24
Q

Do yu want to expel the air bubble in profiled syringes?

A

no!!!!!!!

25
Q

teriflunomide

fingolimod

dimethyl fumarate

diroximal fumarate

siponimod

What drug class?

A

Oral immunomodulators

26
Q

Brand: Aubagio

A

teriflunomide

27
Q

Brand: Gilenya

A

fingolimod

28
Q

Which of the oral immunomodulators are contraindicated in pregnancy?

A

teiflunomide

29
Q

Which of the oral immunomodulators cause bradycardia and needs to be monitored for at least 6 hours; contraindicated in those with CVD/stroke

use caution with drugs that cause slow HR

MS can become much worse when stopped

A

fingolimod

30
Q

What drug can cause macular edema and needs to be monitored with eye exams. Also need to monitor LFTs and CBC

A

fingolimod & siponimod

31
Q

Which oral immunomodulator should not be crushed, but chewed and sprinkled on food

A

dimethyl fumarate

diroximal fumarate

32
Q

Which oral immunomodulator is contraindicated with CYP2c93/3 genotype?

A

siponimod

33
Q

What is the name of the drug that is a potassium channel blocker and works by increasing nerve signal conduction; indicated to improve WALKING

A

dalfampridine/ Amprya

34
Q

Brand: natalizumab

A

generic: Tysabri

35
Q

This MAb has a boxed warning for PML and has REMS

A

natalizumab

36
Q

Alemtuzumab

Ocrelizumab

drug class?

A

recombinant humanized MAb *REMS

37
Q

The oral anti-neoplastic

A

cladribine/ Mavenclad

38
Q

What drugs are used for MS symptom control?

A

anticholinergics for incontinence, laxatives for constipation, muscle relaxants, analgesics

propranolol can help with hand tremor

39
Q

Drugs used for symptom control can…

A

worsen other symptoms :(

NAPLEX 21 (60 decks)

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