MS - Kutzer

based on her learning objectives 🫨

what category of MS is this:

temporary periods of relapses, attacks followed by a period of remission, about 85% of patients

a. relapsing-remitting MS (RRMS)

b. primary progressive MS (PPMS)

c. secondary progressive MS (SPMS)

d. progression-relapsing MS (PRMS)

a.

what category of MS is this:

symptoms get steadily worse with NO period of remission, about 10% of patients

a. relapsing-remitting MS (RRMS)

b. primary progressive MS (PPMS)

c. secondary progressive MS (SPMS)

d. progression-relapsing MS (PRMS)

b.

what category of MS is this:

slowly worsening symptoms and neurological function

a. relapsing-remitting MS (RRMS)

b. primary progressive MS (PPMS)

c. secondary progressive MS (SPMS)

d. progression-relapsing MS (PRMS)

c.

about ______ of patients with RRMS convert to SPMS within ______ years

a. 85%, 5-15 years

b. 50%, 10-20 years

c. 10%, 15-25 years

d. 5%, 25-35 years

b.

what category of MS is this:

rare, steadily worsens from onset of first symptom, about 5% of patients

a. relapsing-remitting MS (RRMS)

b. primary progressive MS (PPMS)

c. secondary progressive MS (SPMS)

d. progression-relapsing MS (PRMS)

d.

list tests/tools used for MS diagnosis

CSF analysis (antibodies)

MRI

optic neuritis

gadolinium

what is the most valuable diagnostic tool for MS, that establishes prognosis and disease progression?

MRI

what is a common first symptom of MS?

optic neuritis - lesions on optic nerve

what is gadolinium?

contrast agent

identifies new lesions and disruption of the BBB

what is the dose, frequency, and ROA of Betaseron (Interferon-B)?

250 mcg (8 million units) SQ QOD

what is the dose, frequency, and ROA of Avonex (Interferon-B 1b)?

30 mcg (6 million IU) IM QW

what is the dose, frequency, and ROA of Plegridy (Pegylated IFN-B1a)?

tapering dose SQ BIW

what medication was the first oral DMT (disease modifying therapy) approved for MS?

a. fingolimod

b. siponimod

c. ozanimod

d. ponesimod

a.

list ADRs of fingolimod

bradyarrhythmia/heart block

infections

macular edema

decrease in forced expiratory volume (pts with compromised lung function)

with fingolimod, what do you need to monitor? for how long after the first dose?

monitor for signs of bradycardia for 6 hours after the first dose

concomitant use of __________ is contraindicated with fingolimod

class Ia and III antiarrhythmic agents

what medication needs genetic testing for CYP2C9 polymorphisms?

a. ponesimod

b. cladribine

c. teriflunomide

d. siponimod

d.

what medication has a BBW for hepatotoxicity and teratogenicity?

a. siponimod

b. dimethyl fumarate

c. teriflunomide

d. mitoxantrone

c.

what medications have a lifetime cumulative dose? (SATA)

a. cladribine (mavenclad)

b. alemtuzumab (lemtrada)

c. rituximab (rituxan)

d. mitoxantrone (novantrone)

a. d.

idk if we need to know this

what is the lifetime cumulative dose for cladribine (mavenclad)?

3.5 mg/kg

idk if we need to know this

what is the lifetime cumulative dose for mitoxantrone (novantrone)?

140 mg/m²

what is Pseudobulbar Palsy?

emotional outbursts

dysphonia

dysphagia

what medication is used to treat Pseudobulbar Palsy?

nuedexta

what drugs is nuedexta a combo of?

dextromethorphan + quinidine

what medications should be used cautiously if a patient is depressed? (SATA)

a. siponimod

b. IFN

c. natalizumab

d. nuedexta

b. c.