Multiple Sclerosis Flashcards
What is the treatment for MS exacerbations?
Methylprednisolone IV
What is the 1st line disease modifying therapy for MS?
Interferon beta 1-a or 1-b (injection) = Avonex, Betaseron, Rebif, Extravia
Non- Interferon = glatiramir acetate (Copaxone)
What is the “safety, tried and true” approach to MS?
- Interferon beta 1-a (Avonex, Betaseron, Rebif, Extavia)
- interferon beta 1-b or glatiramir
What is the 2nd line therapy for MS?
Natalizumab (Tysabri) Mitoxantrone (Novantrone) Fingolimod (Gilenya) Teriflunomide (Aubagio) Alemtuzumab (Lemtrada)
Which 2nd Gen/2nd line therapy for MS is the most efficacious?
Natalizumab
What needs to be checked before starting Natalizumab?
Need to check for John Cunningham virus antibodies (could cause multifocal leukoencephalopathy)
What is major side effect of the interferons?
Depression
What are the 3 major adverse drug events for Fingolimod?
- Macular retinal edema
- AV block
- Fatal dissemination of the herpes zoster
What is the major adverse drug event to be concerned for with teriflunomide?
steven johnson’s syndrome
What needs to be monitored in teriflunomide? (4)
- pregnancy
- TB
- LFTs
- CBC
Which MS drug is considered the convenience approach and is category X in pregnancy?
Teriflunomide
Whcih two drugs are considered “convenience” approach to MS?
- Teriflunomide
2. dimethyl fumarate
Dimethyl fumarate ADEs? (3)
- INCREASED LFTs
- Flushing*——–>take with food
- chest tightness
Which drug is taken orally and inhibits dihydroorotate dehydrogenase to prevent proliferation of lymphocytes
teriflunomide
Which drug taken orally for MS prevents NO secretion (which is involved in oxidate stress)?
dimethyl fumarate
