Schriefer: Ms, Als, And Alzheimers

Front 1

What is the cause of MS?

Back 1

MS is an autoimmune dz with cell-mediate attack on Myelin Basic Protein

Front 2

What dz leads to multiple affected areas of CNS leading to multiple deficits, plaque formation, chronic, relapsing-remitting pattern?

Back 2

MS

Front 3

What drug = Interfereon beta-1b?

Back 3

Betaseron

Front 4

What drugs = interferon beta-1a?

Back 4

Avonex and Rebif

Front 5

What is the MoA of Betaseron?

Back 5

Uncertain--immunomodulaotory actions? IFNB's decrease antigen presentation w/in the CNS which appears to LIMIT immune attack on myelin.

Front 6

What is the MoA of Avonex and Rebif?

Back 6

These are INF-A. MoA is uncertain but perhaps immunomodulatory?

Front 7

What drug to treat MS is a synthetic compound which resembles myelin basic protein?

Back 7

Glatiramer

Front 8

This drug's MoA is to resemble a component of myelin, it's thought that it may protect myelin by acting as a "decoy" attracting immune cells away from myelin.

Back 8

Glatiramer

Front 9

This drug's MoA is to resemble a component of myelin, it's thought that it may protect myelin by acting as a "decoy" attracting immune cells away from myelin.

Back 9

Glatiramer

Front 10

What drug is a CHEMOTHERAPEUTIC agent that is approved to treat advanced MS?

Back 10

Mitoxantrone

Front 11

What drug acts by suppressing immune attack on myelin?

Back 11

Mitoxantrone

Front 12

What MS drug is a recombinate humanized monoclonal ANTIBODY?

Back 12

Natalizumab

Front 13

What is the MoA of Natalizumab?

Back 13

binds to the α4 – subunit of the cell surface ADHESION molecule α4B1 integren expressed on activated lymphocytes and monocytes. This blocks cell adhesion and prevents leukocyte migration across the BBB, interrupting immune attack on myelin.

Front 14

What class of drugs for MS are used for management of ACUTE symptoms b/c they close the damage BBB and reduce inflammation?

Back 14

Steroids: methylprednisolone, dexamthasone, prednisone, betamethasone, prednisolone

Front 15

What agents are used to treat depression associated with MS?

Back 15

both SSRIs FLUOXETINE[Prozac]) and tricyclics (e.g., AMYTRIPTILINE [Elavil]) are used to treat depression associated with MS.
No ATYPICALS!

Front 16

What drugs are used to treat NEURALGIA associated w/damaged nerves from MS?

Back 16

Amitriptyline and Carbamzepine.

Front 17

Drug use to treat urinary incontinence from MS?

Back 17

Imipramine

Front 18

What drugs are used to treat muscle cramping/spasms and spasticity in MS?

Back 18

benzos, clonazepam, BACLOFEN, TIZANDIINE, DANTROLENE

Front 19

What antiviral treats tremors and fatigue associated with MS?

Back 19

Amantadine

Front 20

What drug is used to treat vertigo assoc with MS?

Back 20

Meclizine (H1 blocker)

Front 21

What two drugs are used for urinary incontinence associated with Ms?

Back 21

Oxybutanin and Imipramine

Front 22

What drugs are used for neuralgia associated with MS?

Back 22

Carbamazepine, Phenytoin, Amitryptiline

Front 23

What is the difference between the interferons: Betaseron, Rebif, and Avonex?

Back 23

Betaseron and Rebif are given by alternate day sc. injections, while

Avonex is given by WEEKLY im. injection.

Front 24

What is the worse adverse rxn associated with Betaseron, Rebif, and Avonex?

Back 24

Antibody formation!

Front 25

What are AR's of Glatiramer (MBP)?

Back 25

1. Flushing, chest tightness, SOB (resembles MI)
2. joint pain/muscle stiffness

Front 26

Which drug has an AR of Progressive Multifocal Leukoencephalopathy (PML)?

Back 26

Natalizumab

Front 27

What drug that treats MS should only be used for 2-3 years d/t cumulative effects of CARDIAC CONDUCTION?

Back 27

Mitoxantrone (chemotherapeutic agent)

Front 28

What is the effect of antibody formation while on Betaseron, Rebif, or Avonex?

Back 28

Limits effect of drug

Front 29

What drug is used to treat ALS, a dz of motorneurons in which glutamate "excitotoxicity" may be responsible for the dz?

Back 29

Riluzole

Front 30

How does Riluzole (treats ALS) work?

Back 30

It's a voltage-gated Na+ blocker which inhibits GLUTAMATE release.

Front 31

What is an important AR of Riluzole?

Back 31

It's metabolized by hepatic systemic and can cause HEPATOXOCITY including SGPT elevations. You should monitor liver chemistry.

Front 32

Why use Acetylcholinesterase inhibitors to treat Alzheimers?

Back 32

The cognitive deficits of the disease are thought to be related, in part, to degeneration of cholinergic neurons in the cortex and hippocampus resulting in deficient cholinergic neurotransmission. Acetylcholinesterase inhibitors INCREASE cholinergic activity by DECREASING metabolism of ACh.

Front 33

Donepezil

Back 33

Acetylcholinesterase inhibitor to treat Alzheimers

Front 34

Galantamine

Back 34

Acetylcholinesterase inhibitor to treat Alzheimers

Front 35

Rivastigmine

Back 35

Acetylcholinesterase inhibitor to treat Alzheimers

Front 36

Tacrine

Back 36

Acetylcholinesterase inhibitor to treat Alzheimers

Front 37

What drug acts as a "Use-Dependent NMDA receptor antagonist" for the treatment of Alzheimers?

Back 37

Memantine

Front 38

What is the MoA of Memantine?

Back 38

Blocks glutaminergic overstimulation of NMDA receptors.