L40-41 Pharmacotherapy of MS Flashcards
a first demyelinating event involving the optic nerve, cerebrum, cerebellum, brainstem or spinal cord.
A. Clinically Isolated Syndrome (CIS)
B. Relapsing Remitting MS (RRMS)
C. Secondary Progressive MS (SPMS)
D. Primary Progressive MS (PPMS)
E. Primary Relapsing MS (PRMS)
A. Clinically Isolated Syndrome (CIS)
Most common type, consists of relapses with partial or complete remission between relapses, most will become progressive overtime
A. Clinically Isolated Syndrome (CIS)
B. Relapsing Remitting MS (RRMS)
C. Secondary Progressive MS (SPMS)
D. Primary Progressive MS (PPMS)
E. Primary Relapsing MS (PRMS)
B. Relapsing Remitting MS (RRMS)
80% of RRMS patients with progress to this, consisting of fewer relapses with continuing disability
progressive overtime
A. Clinically Isolated Syndrome (CIS)
B. Relapsing Remitting MS (RRMS)
C. Secondary Progressive MS (SPMS)
D. Primary Progressive MS (PPMS)
E. Primary Relapsing MS (PRMS)
C. Secondary Progressive MS (SPMS)
10-15% of pts. Progressive form from onset with minor improvements or periods of stability; more common in pts diagnosed in later years. (>50 yo)
A. Clinically Isolated Syndrome (CIS)
B. Relapsing Remitting MS (RRMS)
C. Secondary Progressive MS (SPMS)
D. Primary Progressive MS (PPMS)
E. Primary Relapsing MS (PRMS)
D. Primary Progressive MS (PPMS)
least common form; steadily worsening disease from onset with later, clear, acute relapses; may be some recovery from acute attacks, but no remission between relapses.
A. Clinically Isolated Syndrome (CIS)
B. Relapsing Remitting MS (RRMS)
C. Secondary Progressive MS (SPMS)
D. Primary Progressive MS (PPMS)
E. Primary Relapsing MS (PRMS)
E. Primary Relapsing MS (PRMS)
what is EDSS? what do we use it for?
the expanded disability status scale. Used in clinical trials and clinically to access effectiveness of drug therapy.
what is our target EDSS?
4 or lower
First choice for tx of acute attacks
high dose corticosteroid, oral or IV
what is the inpatient corticosteroid tx regimen (drug and duration)
methylprednisolone 500mg-1000mg IV daily for 3-7 days. with or without oral taper over 1-3 weeks.
what is the outpatient corticosteroid tx regimen (drug and duration)
oral prednisone 1250mg every other day for 5 doses without need for taper
oral medications for MS (you can just say the classes)
fumarates, -imods, teriflunomide
injectable MS meds (you can just say the classes)
interferons, glatiramer acetate
infusion MS meds
the -zumabs
what should pts get screened for prior to starting MS meds?
PML/ John Cunningham virus
what specific drug is highlighted for no live virus vaccines on the slide?
Alemtuzumab
T or F: Fumarates are associated with PML(just dimethly?)
False
what two things do you monitor for fumarates?
LFTs (hepatotoxicity) and CBC with differential (neutropenia)
What medication class can cause flushing?
fumarates