Multiple Sclerosis

Card Set Information

Author:
giddyupp
ID:
75137
Filename:
Multiple Sclerosis
Updated:
2011-04-30 12:28:06
Tags:
Multiple Sclerosis PHPR524 Test5
Folders:

Description:
Multiple Sclerosis
Show Answers:

Home > Flashcards > Print Preview

The flashcards below were created by user giddyupp on FreezingBlue Flashcards. What would you like to do?


  1. What is the pathophysiology of MS?
    • Autoreactive T-cells activate an immune response against components of myelin
    • Demyelination causes disruption of nerve conduction
    • Neurologic sx depend on area damaged
    • Scar tissue forms (lesions or plaques)
    • Cumulative axonal damage leads to progressive, irreversible disabilities
  2. What is the clinical presentation of MS?
    • Fatigue
    • Depression
    • Multitude of other neuron-based sx
  3. What is the definition of relapse in MS?
    newly developed sx that continue for at least 24h and are at least 30d apart
  4. What is a Clinically isolated syndrome (CIS) in MS?
    1st demyelinating event (relapse)
  5. What is the definition of remission in MS?
    complete or incomplete resolution of sx
  6. What are the classifications of MS?
    • Relapsing-remitting (RRMS)
    • Secondary-progressive (SPMS)
    • Primary-progressive (PPMS
    • Progressive-relapsing (PRMS)
  7. What is are the characteristics of Secondary-progressive MS (SPMS)?
    • Less frequent relapses than RRMS, but Less complete recover and gradual worsening of sx
    • Significant accumulation of disability
  8. What are the characteristics of Primary-progressive MS (PPMS)?
    • NO relapses
    • Progressive worsening and accumulation of disability from disease onset
  9. What are the characteristics of Progressive-relapsing MS (PRMS)?
    • Mixture of relapses and desease progression
    • Rare
  10. What are the characteristics of Relapsing-remitting MS (RRMS)?
    Relapses occur, but sx generally resolve until next exacerbation
  11. What is the treatment for relapse of MS?
    • Mild relapse may not require drug tx
    • High-dose CS for 3-5d with or without subsequent oral prednisone taper for 1-3wks
  12. What are the Disease Modifying Therapy drugs used in MS?
    • IFN B-1a (Avonex)
    • IFN B-1a (Rebif)
    • IFN B-1b (Betaseron)
    • IFN B-1b (Extavia)
    • Glatiramer (Copaxone)
    • Fingolimod (Gilenya)
    • Natalizumab (Tysabri)
    • Mitoxantrone (Novantrone)
  13. Which DMT drugs are given IM for MS?
    IFNs (Avonex, Rebif, Betaseron, Extavia)
  14. Which DMT drugs are given SQ for MS?
    • IFNs (Avonex, Rebif, Betaseron, Extavia)
    • Glatiramer (Copaxone)
  15. Which DMT drug is given PO for MS?
    Fingolimod (Gilenya)
  16. Which DMT drugs are given IV for MS?
    • Natalizumab (Tysabri)
    • Mitoxantrone (Novantrone)
  17. What type of MS is IFN B good for?
    • RRMS
    • Maybe CIS or SPMS if pt still having relapses
  18. What is the MOA of IFN B in MS?
    • Unknown:
    • Interfere with antigen presentation
    • Anti-inflammatory
    • Inhibition of pro-inflammatory cytokines
    • Inhibition of T-cell proliferation and migration across BBB
  19. What type of MS is Glatiramer (Copaxone) good for?
    • RRMS
    • Maybe for CIS
  20. What is the MOA of Glatiramer (Copaxone) in MS?
    • Unknown:
    • Interfere with antigen presentation and T-cell activation by competing with MBP for binding at the MHC
    • Induce a shift from TH1 (inflammatory to TH2 (anti-inflammatory)
  21. What type of MS is Fingolimod (Gilenya) good for?
    Indicated to reduce frequency of exacerbations and delay accumulation of physical disability in relapsing forms of MS
  22. What type of MS is Natalizumab (Tysabri) good for?
    Monotherapy for relapsing forms of MS
  23. What is the MOA of Natalizumab (Tysabri) in MS?
    alpha-4 integrin inhibitor preventing activated lymphocytes from crossing the BBB
  24. What type of MS is Mitoxantrone good for?
    SPMS, PRMS, and worsening RRMS
  25. What is the MOA of Mitoxantrone in MS?
    Interferes with RNA and DNA synthesis and DNA repair
  26. What are the SE of IFN B?
    • Flu-like sx
    • Injection site reactions (mainly SQ)
    • Neutralizing antibodies
  27. What are the SE of Glatiramer (Copaxone)?
    • Injection site rxns
    • Transient rxn (flushing, chest tightness, dyspnea, palpitations, anxiety - only occurs once, usually lasts <20min)
  28. What are the SE of Mitoxantrone?
    • Cardiotoxicity
    • Alopecia
    • Amenorrhea
    • Secondary AML
  29. What are the off-label tx for MS?
    • Cyclophosphamide
    • Azathioprine
    • MTX
    • IVIG
    • Methylprednisolone
    • Plasma exchange
  30. What is Dalfampridine used for in MS?
    • to improve walking (ONLY!)
    • Potassium channel blocker
    • Dose-dependent seizure risk
    • Do not cut, crush, or chew

What would you like to do?

Home > Flashcards > Print Preview