MS drugs

Question 1

diemethyl fumarate warning and ADR

Answer 1

leukopenia, fushing redness, rash

warn: liver toxicity

Question 2

metabolite of dimethyl fumarate

Answer 2

MMF - a nictotinic acid receptor agonist

Question 3

fingolimod MOA

Answer 3

sphingosine 1 phosphate receptor modulator

keeps WBC in ymphnodes so don’t cross BBB

Question 4

ADRs for fingolimod

Answer 4

varicella zoster, PML, abnormal LFTs, cough, increased mortality

Question 5

Teriflunomide moa

Answer 5

pyrimidine synthesis inhibitor: inhibits immune cells

Question 6

teriflunomide is only indicated for..

Answer 6

relapsing forms of MS

Question 7

teriflunomide 6+ warnings

Answer 7

hepatotoxic, teratogenic, bone marrow suppression, peripheral neuropathy, high K, transient renal failure

adr: alopecia, D/N, messed up LFT

Question 8

what is dalfampridine MOA and niche

Answer 8

MOA: potassium channel blocker
- increases condition of AP in demyelinated axons

indicated for walking improvement

Question 9

2 contraindications of dalfampridine

Answer 9

renal impairment, and seizures

Question 10

what do you need to monitor with IVIG?

Answer 10

renal function

Question 11

dontrolene is a ___

Answer 11

muscle relaxant - used in spasticity in MS

Question 12

dantrolene first line for and CI

Answer 12

malignant hyperthermia

CI in active liver dz

Question 13

nuedexta is first line for

Answer 13

pseudobulbar affect in MS

Question 14

what combo is nuedexta?

Answer 14

dextromethorphan and quinidine
METABOLIZED BY 2D6
yet quinidine is a 2D6 inhibitor so increases BA by 20 times so dextro can crosss the BBB
dextromethorphan half life goes from 2 to 13 hours

Question 15

nuedexta CI

Answer 15

long QT, AV block

Question 16

interferon b treats

Answer 16

RRMS or SPMS with relapses

main ADR: 48 hrs of flu

Question 17

glatiramer acetate main ADR

Answer 17

lipoatrophy and skin necrosis

Question 18

Mitoxantrone unique facts

Answer 18

blue drug

used to do chemo - toperimase, PReg D

Question 19

besides MS what does mitoxantrone treat?

Answer 19

hormone refractory prostate CA

acute leukemia adults

Question 20

mitoxantrone ADR

Answer 20

cardiotoxicity CI if LVEF is less than 50%

Question 21

natalizumab moa

Answer 21

binds up wbc in lymphnodes so cant go in BBB
used in combo with interferon
delays disability in relapsing MS

Question 22

warnings of natalizumba

Answer 22

PML

limited use .. need restricted program for rx