front 1 What are the two treatments for MS exacerbations | back 1 1. CCS 2. ACTH |
front 2 What is the 1st line CCS | back 2 methylprednisolone |
front 3 Sleep disturbances, metallic taste (PO), GI upset, and hyperglycemia are short term side effects of what class of drugs | back 3 CCS |
front 4 What is the only FDA approved treatment for MS exacerbations | back 4 ACTH $ |
front 5 first generation disease modifying therapies for MS: | back 5 4 interferon produces Glatiramer acetate |
front 6 4 IFN products: | back 6 1. Avonex 2. Rebif 3. Betaseron/Extavia 4. Plegridy |
front 7 What is the dosing for Avonex | back 7 6 million units IM weekly |
front 8 What is the dosing for Rebif | back 8 22 mcg SQ three times weekly given at least 48 hours apart |
front 9 What is the dosing for Betaseron/Extavia | back 9 8 million units SQ every other day |
front 10 What is the dosing for Plegridy | back 10 6.3 mcg SQ every 14 days |
front 11 Which two IFN products are high potency | back 11 Rebif Betaseron/Extavia |
front 12 Which IFN produce has more injection site reactions | back 12 Betaseron/Extavia |
front 13 Pre-medication with antipyretics can be useful with which agent | back 13 Plegridy |
front 14 4 ADRs of IFN therapy | back 14 1. Psychiatric issues 2. Flu-like symptoms 3. Injection site reactions 4. Increased LFTs |
front 15 IFN therapies should be refrigerated up until administration? | back 15 False Let sit at room temperature and do not expel air bubble in profiled syringes |
front 16 Risk of Creutzfeldt-Jakob disease transmission is increased with IFN therapy with formulations containing albumin? | back 16 True |
front 17 What is the preferred agent in pregnancy? | back 17 Copaxone/Glatopa |
front 18 Copaxone/Glatopa dosing: | back 18 20 mg SQ three times a week |
front 19 All 1st generation medications may not show efficacy until 1-2 years after starting? | back 19 True |
front 20 ADRs of glatiramer acetate | back 20 Chest pain Diaphoresis Dyspnea Flushing Injection site reactions |
front 21 All sphingosine-1-phosphate receptor modulators are CI in what conditions | back 21 1. MI 2. Unstable angine 3. Stroke/TIA 4. Class III/IV or hospitalization for HF in the last 6 months |
front 22 4 sphingosine-1-phosphate receptor modulators | back 22 1. Gilenya 2. Zeposia 3. Ponvory 4. Mayzent |
front 23 Relapsing forms of MS are treated with | back 23 sphingosine-1-phosphate receptor modulators |
front 24 Gilenya | back 24 Fingolimod |
front 25 Zeposia | back 25 Ozanimod |
front 26 Ponvory | back 26 Ponesimod |
front 27 Mayzent | back 27 Siponimod |
front 28 All sphingosine-1-phosphate receptor modulators are given by what route` | back 28 Oral |
front 29 what should be screened for for all sphingosine-1-phosphate receptor modulators | back 29 Latent infections |
front 30 What sphingosine-1-phosphate receptor modulator is CI in severe untreated sleep apnea and concomitant use of MAOI | back 30 Zeposia |
front 31 What sphingosine-1-phosphate receptor modulator is CI in CYP2C9*3/*3 genotype | back 31 Mayzent |
front 32 What sphingosine-1-phosphate receptor modulator is CI with class Ia and III anti arrhythmic agents | back 32 Gilenya- QTc prolongation |
front 33 Gilenya has what risk? | back 33 PML |
front 34 Patients must be monitored for 6 hours post dose for what two sphingosine-1-phosphate receptor modulators | back 34 Gilenya Mayzent |
front 35 ADRs of sphingosine-1-phosphate receptor modulators | back 35 Bradycardia/bradyarrhythmias- ECGs Macular edema- Eye exams Fetal risk Hepatotoxicity- LFTs |
front 36 Nuclear factor-like-2-activators | back 36 Tecfidera (dimethyl fumigate) Vumerity (Diroximel fumigate) Bafiertam (monomethyl fumurate) |
front 37 All nuclear factor-like-2-activators are given by what route | back 37 Oral |
front 38 Nuclear factor-like-2-activators can be crushed, chewed, and sprinkled on food for patients who are not good at swallowing medications? | back 38 False |
front 39 Main ADR of Nuclear factor-like-2-activators | back 39 Flushing |
front 40 How to treat flushing associated with Nuclear factor-like-2-activators? | back 40 Take aspirin 30 minutes before and administer with food |
front 41 Brand name of teriflunomide | back 41 Aubagio |
front 42 CI of Aubagio | back 42 Pregnancy or not using adequate protection |
front 43 Cholestyramine can be used for accelerated elimination of what medication? | back 43 Aubagio |
front 44 ADRs of Aubagio | back 44 Alopecia N/D Lymphocytopenia Infection risk |
front 45 What are the two monoclonal antibodies | back 45 Tysabri (Natalizumab) Kesimpta (Ofatumumab) |
front 46 Which moAb binds to the alpha-4 subunit of intern on lymphocytes | back 46 Tysabri |
front 47 Dosing of Tysabri | back 47 300 mg IV over 1 hr q 4 weeks |
front 48 Which moAb is an anti-CD20 | back 48 Kesimpta Ocrevus Briumvi |
front 49 Dosing of Kesimpta | back 49 20 mg SQ once weekly for 3 doses then once monthly starting at week 4 |
front 50 Which drug is under the REMS program for PML? | back 50 Tysabri |
front 51 Which agent can be initial first line therapy in severe RRMS | back 51 Tysabri |
front 52 Which agent has a CI for active HepB infection | back 52 Kesimpta |
front 53 What agent should be screened for John Cunningham virus? | back 53 Tysabri |
front 54 Which agent is the only agent that has an indication for PPMS? | back 54 Ocrevus |
front 55 Which moAbs are given IV | back 55 Tysabri Lemtrada Ocrevus Briumvi |
front 56 Which agent has a REMS program for autoimmunity, infusion reactions, and malignancies | back 56 Lemtrada |
front 57 Pre-medications with steroids +/- antipyretics and ppx with acyclovir would be beneficial with which moAb? | back 57 Lemtrada |
front 58 Pre-medication with methylprednisolone IV and antihistamine 30-60 minutes before infusion +/- APAP | back 58 Ocrevus |
front 59 Pre-medication with methylprednisolone IV and antihistamine and considering an antipyretic would be beneficial with which moAb? | back 59 Briumvi |
front 60 All vaccinations should be completed how long before treatment | back 60 6 weeks |
front 61 ADRs of Alemtuzumab (Lemtrada) | back 61 Rash Thyroid disease Lymphocytopenia Antibody development |
front 62 What is only oral anti-neoplastic agent? | back 62 Mavenclad (cladribin) |
front 63 Mavenclad can be used to treat | back 63 RRMS and SPMS |
front 64 What agent has a boxed warning for malignancies and teratogenicity requiring 6 months of contraception? | back 64 Mavenclad |
front 65 CI of Mavenclad | back 65 Malignancy, HIV, or active chronic infections |