UNIT 2- MULTIPLE SCELORIS MEDS

Question 1

What is the MOA of disease-modifying drugs 1 such as Immunomodulators?

Answer 1

decrease future disability, reduce development of brain lesions and decrease the severity and frequency of relapses

Question 2

What are the different types of disease modifying drugs 1- immunomodulators?

Answer 2

1. Interferon beta 1a- (rebif, plegridy, avonex)
2. Interferon beta 1b- (betaseron, extavia)
3. Glatirmer acetate
4. Teriflunomide (aubago)

Question 3

True or false: All patients regardless of age should take immunomodulators?

Answer 3

True

Question 4

What is the disease modifying drug I- Interferon B?

Answer 4

1. It is a naturally occurring glycoprotein w/antiviral, antiproliferative and immunomodulatory actions.

Question 5

What is the therapeutic use of Interferon b (modifying drug I immunomodulator)

Answer 5

1. Reduces frequency and severity of attacks
2. Reduces the number and size of lesions detectable with MRI
3. Delays progression of disability

Question 6

What are adverse effects of interferon B?

Answer 6

1. Flu-like symptoms
2. Hepatotoxicity** (monitor lft, cbc)
3. Myelosuppression-
4. Injection site reaction (tx pt how to self inject)
5. depression/suicidal thoughts
6. Drug interactions

Question 7

How is interferon B administered?

Answer 7

Injections

Question 8

What are types of disease modifying drugs II?

Answer 8

Immunosuppressants (developed originally for cancer patients)

Question 9

What is a type of modifying drugs II- immunosuppresant?

Answer 9

1. Mitoxantrone (navantrone)

Question 10

True or false: Mitoxantrone is not as toxic as immunomodulators?

Answer 10

1. False

Question 11

What is the MOA of Mitoxantrone (Immunosuppressant- modifying drugs II)

Answer 11

1. Binds w/DNA and inhibits topoisomease
2. Produce greater suppression of immune function which can delay time to relapse and the time of disability progression

NOT effective w/primary progression because this drug aims to slow down relapse which primary progression patients do not have.

Question 12

What is the therapeutic use of Mitoxantrone (immunosuppressant- modifying drugs II)

Answer 12

1. Decrease neurologic disability and clinical relapse

Question 13

What are the 3 major adverse effects and drug interactions of mitoxantrone (immunosuppressant- modifying drugs II)

Answer 13

1. Myelosuppression– fever cough chills– notify MD!!
2. Cardiotoxicity
3. Fetal harm

can also cause reversible hair loss, injury to GI mucosa, n/v, amehorrhea, allergy symptoms, BLUE-GREEN- tint to urine and scelera

Question 14

What other drugs can be used to manage MS exacerbations?

Answer 14

1. Corticosteroids (prednisone and methylprednisolone)
   -Helpful in tx of acute exacerbation as it reduces edema and acute inflammation at site of demyelination
2. Therapeutic plasma exchange and IV Therapeutic (IVIG)– given if corticosteroids aren’t working