MS

Question 1

Natalizumab

Answer 1

a-integrin ab (prev adhesion of lymph), monitoring program, PML

Question 2

Fingolimod

Answer 2

binds and internalizes S1P (sphingosine-1 phosphate) receptors on lymphocytes so can’t migrate out of lymph nodes, MACULAR edema, brady (1st dose), VZV (vaccinate first)

Question 3

Alemtuzumab

Answer 3

CD52 lead to lysis of B/T cells, approved after 2 failed DMTs (severe AE), hyperthyroid, ITP, ppx acyclovir

Question 4

Dimethyl fumarate

Answer 4

unclear, GI sx, heptotox, flushing (imp after 3m, pretreat ASA)

Question 5

Teriflunomide

Answer 5

inh mitochondrial dihydroorotate dehydrogenase (pyrimidine synth), diarrhea, alopecia, teratogenic (cholesthyramine if wants to get preg to remove)

Question 6

Dalfampridine

Answer 6

sx not DMT, for WALKING, 4-aminopyridine (inhibit VGK channels, improve conduction), SEIZUREs

Question 7

Glatiramer acetate

Answer 7

injection site, anxiety/CP/flushing

Question 8

Ocrelizumab

Answer 8

CD20, infusion rx

Question 9

Siponimod

Answer 9

aggressive freq relapse MMS, check CYP2C9