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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
Q

What are AEs of ocrelizumab (Ocrevys)? (2)

A

infusion reactions, infection susceptibility

26
Q

What are contraindications for ocrelizumab (Ocrevys)?

A

active HBV infection

27
Q

What is the MOA of ofatunumab (Kesimpta)?

A

targets CD20 causing reduction of circulating B-cells

28
Q

What are AEs for ofatunumab (Kesimpta)? (2)

A

infection susceptibility, HA

29
Q

What is the MOA of mitoxantrone?

A

intercalates with DNA and inhibits topoisomerase II

30
Q

What is mitoxantrone also indicated for?

31
Q

What is the dosing and ROA for mitoxantrone?

A

12 mg/m^2 IV q3 months

32
Q

What are AEs for mitoxantrone? (2)

A

cardiotoxicity, bone marrow suppression

33
Q

What is the indication for cladribine (Mavenclad)?

A

RRMS and SPMS but NOT CIS

34
Q

What is the MOA of cladribine (Mavenclad)?

A

nucleoside analogue; cytotoxic effects on B and T lymphocytes

35
Q

What is the dosing and ROA for cladribine (Mavenclad)?

A

10 mg PO for two years

36
Q

What are contraindications for cladribine (Mavenclad)? (2)

A

pregnancy, current malignancy

37
Q

What are AEs for cladribine (Mavenclad)? (2)

A

HA, infection

38
Q

What is the MOA of fingolimod (Gilenya)?

A

S1P receptors; depletes T lymphocytes

39
Q

What is the indication for fingolimod (Gilenya)?

A

RRMS, SPMS and CIS

40
Q

What is needed prior to initiating fingolimod (Gilenya)? (3)

A

ECG, bloodwork, and eye exam

41
Q

What are contraindications for fingolimod (Gilenya)?

A

heart problems

42
Q

What is the MOA of siponimod (Mayzent)?

A

S1P receptors; blocks lymphocytes emigration from lymph nodes

43
Q

What is the indication for siponimod (Mayzent)?

A

RRMS, SPMS and CIS

44
Q

What is the genotype that is contraindicated for siponimod (Mayzent) use?

45
Q

What is the genotype that requires dose adjustment for siponimod (Mayzent) use? (2)

A

CYP2C91/3 and 2/3

46
Q

What are AEs of siponimod (Mayzent)? (3)

A

infections (PML), macular edema, heart issues (QTc prolongation, bradycardia)

47
Q

What is the MOA of ozonimod (Zeposia)?

A

S1P receptors; blocks lymphocytes emigration from lymph nodes

48
Q

What are contraindications for ozonimod (Zeposia)?

A

heart issues

49
Q

What are AEs of ozonimod (Zeposia)?

50
Q

What is the MOA of teriflunomide (Aubagio)? (2)

A

blocks pyrimidine synthesis, decreases the ability of antigen-presenting cells to active T-cells

51
Q

What is the indication for teriflunomide (Aubagio)?

A

RRMS and SPMS

52
Q

What are AEs of teriflunomide (Aubagio)? (3)

A

infection, alopecia, paresthesias

53
Q

What are BBWs for teriflunomide (Aubagio)? (2)

A

hepatoroxicity, teratogenicity

54
Q

What are DDIs for teriflunomide (Aubagio)? (3)

A

contraceptives, statins, warfarin

55
Q

What is the MOA of dimethyl fumarate (Tecfidera)?

A

induces cytokines to cause apoptosis in T cells

56
Q

What is the indication for dimethyl fumarate (Tecfidera)?

A

RRMS, SPMS, and CIS

57
Q

What is the dosing and ROA for dimethyl fumarate (Tecfidera)?

A

240 mg PO bid

58
Q

What are AEs of dimethyl fumarate (Tecfidera)?

59
Q

What is the benefit of diroximel fumarate (Vulmerity) over dimethyl fumarate (Tecfidera)?

A

Less GI symptoms

60
Q

What is the benefit of monomethyl fumarate (Bafiertam) over dimethyl fumarate (Tecfidera)?

A

Less GI symptoms

61
Q

What medications can be used to treat symptoms of MS? (7)

A

baclofen, dantrolene, BZDRAs, tizanidine, gabapentin, Botox, dalfampridine

62
Q

What medication can be used to treat pseudobulbar affect?

PHM701 (14 decks)

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