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Neuropharma > Multiple Sclerosis > Flashcards

Multiple Sclerosis Flashcards

1
Q

Dosing of steroids of MS

A

IV methyprednisolone for 3-5 days then oral 60-80 mg tapering to lower over 12-20 days period

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2
Q

What is the issue with long term administration of interferon

A

Development of antibodies

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3
Q

Route of IFN-B

A

Subcutaneous

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4
Q

Treatment for spatic bladder in MS

A

Propantheline

Oxybutinin

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5
Q

This is a copolymer I that mimics action of MBP

A

Glatiramer

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6
Q

Postural tremor in MS can be treated by

A

INH with pyridoxine

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7
Q

What can be given to ameliorate the flu like symptoms by administration

A

administer steroids

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8
Q

Adverse effects of Glitaramer I

A

Flushing
Chest tightness
Palpitation
Anxiety

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9
Q

Dose of steroids that proven to have reduction of disability as well as degree of brain atrophy on T1W1

A

Methylprednisolone 1g/d for 5 days over 5 years

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10
Q

What is the mechanism of action of fingolimod

A

This is an oral drug that interfere with egress of lymphocytes from lymphnode

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11
Q

Clinical benefit of Natalizumab

A

reduction in the mRI lesion and reduces relapse

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12
Q

What trial compare alemtuzumab to interferon in MS

A

CAMMS223 Trial investigators

superior than interferon

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13
Q

Route of IFN-B-1a

A

Intramuscular

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14
Q

What is the mechanism of action of Rituximab

A

B-cell depleting monoclonal antibody that targets CD20 lymphocytes

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15
Q

How is Alemtuzumab given

A

5 consecutive days annually

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16
Q

Adverse effect of fingolimod

A 
lymphophenia
Bradycardia
AV block
macular edema
Herpes infection
Elevated liver function test
17
Q

Advantage of natalizumab

A

Once monthly dosing and lack of acute side effects

18
Q

Adverse effect of Rituximab

A

lymphoma

19
Q

This medication can hastened the attacks of optic neuritis

A

Steroids

20
Q

Percentage of antibody development

A

30% - daily
18% - alternate use
5% - weekly
2% - one year use

21
Q

Adverse effect of Alemtuzumab

A

ITP and autoimmune thyroiditis

22
Q

Severe disabling tremor can be managed surgically by:

A

ventrolateral thalamotomy

23
Q

This is a nonglycosylated bacterial cell product within amino acid sequence

A

IFN-B-1B

24
Q

What is the condition observed in patient undergo plasma exchange to rapidly clear natalizumab to reverse PML

A

Immune reconstitution inflammatory syndrome (IRIS)

25
Q

IRIS can be ameliorated by

A

Steroids

26
Q

Fatigue in MS can be given

A

Amantadine
Modafinil
Premoline
Dextroamphetamine

27
Q

Monoclonal antibodies

A

Natalizumab
Alemtuzumab
Rituximab

28
Q

AFFIRM study

A

Natalizumab,
68% reduction of relapse
80% reduction of T2 lesion
96% reduction in gadolinium enhancing lesion

29
Q

Steroids hastened the optic neuritis by how many months

A

6 months

30
Q

What is the management for urinary retention in MS

A

Betanechol

31
Q

pain symptoms in MS can be given

A

CBZ or Gabapentin

32
Q

Result of PRISM Study

A

IFN-B-1B delayed the progression of the disease for 9-12 months in a period of 2-3 years

33
Q

What is the mechanism of action of Alemtuzumab

A

targets CD 52 reducing the expressed B lymphoctyes and T lymphocytes for longer period.

34
Q

What is the route of administration of Glitaramer

A

SQ

35
Q

SENTINEL Study

A

Study that combined natalizumab and interferon gives better results

36
Q

What is the serious side effect of Natalizumab

A

PML

37
Q

Mechanism of action of Natalizumab

A
  1. Alpha integrin antagonist - blocks lymphocytes and monocytes adhesion to the endothelial cells and their migration to vessel wall

Neuropharma (6 decks)

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