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Pharm Unit 3 Drugs > MS Drugs > Flashcards

MS Drugs Flashcards

1
Q

IFN-beta-1a (Avonex)Misc

A

Doesn’t cross BBB; decreases relapse rate by 1/3 and reduces MRI lesions, with a trend toward decreasing disability and brain atrophy

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2
Q

IFN-beta-1a (Avonex) Class

A

IFN-beta-1a

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3
Q

IFN-beta-1a (Rebif) Class

A

IFN-beta

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4
Q

Glatiramer acetate (Copaxone) Class

A

Myelin basic protein analog

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5
Q

Natalizumab (Tysabri) Class

A

Monoclonal antibody

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6
Q

Fingolimod (Gilenya) Class

A

Sphingosine-1-phosphate analog

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7
Q

Mitoxantrone (Novantrone) Class

A

Anthracenedione

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8
Q

Azathioprine (Imuran) Class

A

Immunosuppressants

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9
Q

Methotrexate (Trexall) Class

A

Immunosuppressants

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10
Q

Cyclophosphamide (Cytoxan) Class

A

Immunosuppressants

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11
Q

Mycophenolate mofetil (CellCept) Class

A

Immunosuppressants

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12
Q

Methylprednisone (MTP) Class

A

Corticosteroid (immunosuppressant)

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13
Q

IFN-beta-1a (Avonex) MOA

A

Many, potentially: inhibit T-cell activation, shift from Th1 to Th2, inhibit lymphocyte movement into CNS, anti-proliferative effect, apoptosis of T-cells, anti-viral, IFN-g antagonism

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14
Q

IFN-beta-1a (Rebif) MOA

A

Many, potentially: inhibit T-cell activation, shift from Th1 to Th2, inhibit lymphocyte movement into CNS, anti-proliferative effect, apoptosis of T-cells, anti-viral, IFN-g antagonism

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15
Q

Glatiramer acetate (Copaxone) MOA

A

Mixture of 4 AAs in myelin basic protein; causes T-cell apoptosis (looks like MBP), induces anti-inflammatory Th2 cells (cytokine shift from Th1), induces Treg with induction of anergy

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16
Q

Natalizumab (Tysabri) MOA

A

Binds VLA4 (integrin subunit), inhibiting leukocyte migration across BBB

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17
Q

Fingolimod (Gilenya) MOA

A

Prodrug; sequesters circulating lymphocytes in secondary lymphoid organs via induction of intracellular internalization of receptors on lymphocytes (no effect on lymphocyte induction, proliferation, or memory function)

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18
Q

Dimethyl fumarate (Tecfidera) MOA

A

Enhances Nrf2 pathway; some Th1 -> Th2 sgift

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19
Q

Mitoxantrone (Novantrone) MOA

A

Broad immune suppression and modulation of B cells, T cells and macrophages; decreases frequency of clinical relapse, reduces disease progress, and reduces disability

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20
Q

Azathioprine (Imuran) MOA

A

Immunosuppressive

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21
Q

Methotrexate (Trexall) MOA

A

Immunosuppressive

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22
Q

Cyclophosphamide (Cytoxan) MOA

A

Immunosuppressive

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23
Q

Mycophenolate mofetil (CellCept) MOA

A

Immunosuppressive

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24
Q

Methylprednisone (MTP) MOA

A

Unclear mechanism (suppress both B and T cells, may reduce cytokine release)

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25
Q

Plasmapharesis MOA

A

Unclear mechanism

26
Q

IFN-beta-1a (Avonex) Therapeutics

A

RRMS

27
Q

IFN-beta-1a (Rebif) Therapeutics

A

RRMS (high-dose); first-line treatment (more efficacious than Avonex in head-to-head trials)

28
Q

Glatiramer acetate (Copaxone )Therapeutics

A

RRMS

29
Q

Natalizumab (Tysabri) Therapeutics

A

RRMS (2nd line)

30
Q

Fingolimod (Gilenya) Therapeutics

A

RRMS

31
Q

Dimethyl fumarate (Tecfidera) Therapeutics

A
32
Q

Mitoxantrone (Novantrone) Therapeutics

A

SPMS; RRMS (2nd line)

33
Q

Azathioprine (Imuran) Therapeutics

A

SPMS (resistant, or as combination with other therapies)

34
Q

Methotrexate (Trexall) Therapeutics

A

SPMS (resistant, or as combination with other therapies)

35
Q

Cyclophosphamide (Cytoxan) Therapeutics

A

SPMS (resistant, or as combination with other therapies)

36
Q

Mycophenolate mofetil (CellCept) Therapeutics

A

SPMS (resistant, or as combination with other therapies)

37
Q

Methylprednisone (MTP) Therapeutics

A

Acute MS attack, SPMS; shortens acute attack duration,speeds recovery

38
Q

ACTH Therapeutics

A

Acute MS attack (if patient allergic to corticosteroids, poor IV access); or if MTP doesn’t work

39
Q

Plasmapharesis Therapeutics

A

Acute MS attack not responsive to MTP

40
Q

IFN-beta-1a (Avonex) SE

A
  1. Mild anemia, increase LFT (monitor every 6 mo.), hypothyroid; least NAB formed 2. Flu-like, minor irritation at inject site, anemia
41
Q

IFN-beta-1a (Rebif) SE

A
  1. Anemia, leukopenia, menstrual irregularities, depression, increase LFT and hypothyroidism (monitor every 3 mo.) 2. Flu-like, injection site reaction; neutropenia; thrombocytopenia
42
Q

Glatiramer acetate (Copaxone ) SE

A

Mild: injection site reaction, anxiety attack-like reaction

43
Q

Natalizumab (Tysabri) SE

A
  1. PML (JC virus); acute urticaria, systemic hypersensitivity infusion reaction 2. Headache, dizziness, fatigue, arthralgia, rigors
44
Q

Fingolimod (Gilenya) SE

A
  1. Bradycardia and heartblock (EKG for first 6 hours); macular edema (need opthalmology exam before and after 3 months) 2. Reduced FEV1, increased LFTs, lymphopenia, leukopenia, asthenia, back pain, blurred vision, headache dizziness, infections
45
Q

Dimethyl fumarate (Tecfidera) SE

A
  1. N & V; diarrhea; stomach pain; flushing 2. Itching, redness, rash
46
Q

Mitoxantrone (Novantrone) SE

A
  1. Dose-dependent cardiac toxicity (decreased LVEF, irreversible CHF); induction of acute leukemia 2. Nausea and vomiting, alopecia, menstrual irregularities, increased susceptibility to infection
47
Q

Azathioprine (Imuran) SE

A

Systemic toxicity: monitor blood for changes

48
Q

Methotrexate (Trexall) SE

A

Systemic toxicity: monitor blood for changes

49
Q

Cyclophosphamide (Cytoxan) SE

A

Systemic toxicity: monitor blood for changes

50
Q

Mycophenolate mofetil (CellCept)SE

A

Systemic toxicity: monitor blood for changes

51
Q

Methylprednisone (MTP) SE

A

Short-term: insomnia, mood changes, fluid retention, epigastric pain, hypertension; long-term: osteoporosis, cushingoid, secondary malignancies

52
Q

IFN-beta-1a (Avonex)Misc

A

Doesn’t cross BBB; decreases relapse rate by 1/3 and reduces MRI lesions, with a trend toward decreasing disability and brain atrophy

53
Q

IFN-beta-1a (Rebif) Misc

A

As with Avonex; significantly reduces new and enhancing MRI lesions, reduces disablity

54
Q

Glatiramer acetate (Copaxone ) Misc

A

Active in CNS (not peripherally); try to use early; reduce relapse by 1/3, modest reduction in MRI lesion and reduction of atrophy, but no effect on disease progression

55
Q

Natalizumab (Tysabri) Misc

A

Decrease relapse rate by 2/3, greatly reduce MRI lesions; once/month; antibodies to natalizumab cause it to stop working; side effects more common in patients positive for neutralizing antibodies

56
Q

Fingolimod (Gilenya) Misc

A

Patients must be VZV immune before prescription; oral daily

57
Q

Dimethyl fumarate (Tecfidera) Misc

A

Oral BID

58
Q

Mitoxantrone (Novantrone) Misc

A

IV; once/3 months

59
Q

Mycophenolate mofetil (CellCept) Misc

A

Oral

60
Q

Methylprednisone (MTP) Misc

A

Given IV with oral prednisone taper

Pharm Unit 3 Drugs (13 decks)

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