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NAPLEX > Autoimmune Dx - Multiple Sclerosis (MS) > Flashcards

Autoimmune Dx - Multiple Sclerosis (MS) Flashcards

0
Q

How do pts experience MS?

A

Periods of dx activity ff by intervals of remission

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1
Q

What’s multiple sclerosis (MS)?

A

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)

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2
Q

Primary goal of MS therapy?

A

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

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3
Q

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

A

Mitoxantrone

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4
Q

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

A

Cyclophosphamide

Azathioprine

IV immunoglobulin

Alemtuzumab

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5
Q

What’s the brand name of Glatiramer acetate?

A

Copaxone

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6
Q

MOA of Glatiramer acetate (Copaxone)?

A

Immune modulator, mech not well-defined

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7
Q

SE of Glatiramer acetate (Copaxone)?

A

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

Infection

Pain

Flushing

Diaphoresis

Chest pain

Weakness

Anxiety

Rash

Nausea

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8
Q

Howz Interferon beta-1a (Avonex) used?

A

IM 30mcg weekly

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9
Q

Howz Interferon beta-1a (Rebif) used?

A

SC 22mcg or 44mcg three times per week

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10
Q

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

A

SC: 0.25mg Every other day

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11
Q

SE of interferon beta?

A

Injection site rxns

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12
Q

Which interferon are used SC?

A

Rebif and Betaseron/Extavia

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13
Q

How do u inject Rebif or Betaseron/Extavia?

A

SC injections

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

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14
Q

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

A

No, small air bubbles shouldn’t be expelled.

Bcuz dose may be reduced

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15
Q

What’s Natalizumab?

A

Recombinant humanized monoclonal antibody

16
Q

Brand name of Natalizumab?

A

Tysabri

17
Q

How’s Natalizumab (Tysabri) used?

A

300mg IV given over 1hr, Q4WEEKS

18
Q

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

A

Can cause progressive multifocal leukoencephalopathy (PML)

19
Q

List oral immune modulator agents

A

Fingolimod (Gilenya)

Teriflunomide (Aubagio)

Dimethyl fumarate (Tecfidera)

20
Q

What’s warning associated with Fingolimod (Glienya)?

A

Decrease in heart rate (must monitor)

21
Q

Monitoring parameters for Fingolimod (Gilenya)?

A

CBC (baseline and periodically thereafter)

ECG (baseline; repeat after initial dose observation period)

22
Q

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

A

Postdose symptomatic bradycardia can occur

23
Q

Howz Dimethyl fumarate (Tecfidera) not to be used?

A

Don’t crush, chew or sprinkle content on food

24
Q

MOA of Dalfampridine (Ampyra)?

A

Potassium channel blocker, may increase nerve signal conduction

25
Q

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

A

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
Q

What sx control agent is used for incontinence in MS?

A

Anticholinergic

27
Q

What sx control agent is used for constipation in MS?

A

Laxatives

28
Q

What sx control agent is used for diarrhea in MS?

A

Loperamide

29
Q

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

A

Skeletal muscle relaxants

30
Q

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

A

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

31
Q

What sx control agent is used for tremor in MS?

A

Propranolol

32
Q

What sx control agent is used for depression in MS?

A

Antidepressants

SNRI if chosen can work for both neuropathic pain and depression

33
Q

What sx control agent is used for fatigue in MS?

A

Modafinil or stimulants used in ADHD such as methylphenidate

34
Q

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

A

Meclizine and Scopolamine

35
Q

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

A

Acetylcholinesterase inhibitors, including Donepezil

36
Q

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

A

Can be treated with phophodiesterase inhibitors

NAPLEX (73 decks)

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