Counseling Points Multiple Sclerosis - Spring 2015 - 14

Counseling Points™
Encouraging Monitoring and Follow-up in MS Care

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c. for most patients, as a way to monitor immune cell response
and infection risk
d. primarily for patients with low white blood cell counts at
initiation of therapy

1. Patients with multiple sclerosis (MS) who are on diseasemodifying therapy (DMT) should be monitored for safety
and adverse effects of therapy:

a. at initiation of therapy and after 6 months
b. at initiation of therapy, after 3 months, and then every 6
months thereafter
c. only if the patient complains about adverse effects or if lab
results are abnormal
d. this determination must be individualized for the specific
DMT and the patient's circumstances

6. Progressive multifocal leukoencephalopathy (PML) is
caused when:

a. immunosurveillance of the central nervous system (CNS) is
blocked or inhibited
b. JC virus proliferates in the CNS
c. JC virus invades oligodendrocytes in the CNS
d. all of the above

2. A patient with MS in your practice has been prescribed a
DMT, but 3 months later has not yet filled the prescription. An appropriate course of action would be:

7. True or False? Leukopenia due to treatment with interferon-based DMTs has been associated with serious
opportunistic infections among patients with MS.

a. call the pharmacy and ask them to contact the patient
b. wait another 3 months and then follow up to see if the
patient has started on the drug
c. follow up to determine whether insurance limitations or
prior authorization requirements may be causing a delay
d. assume that the patient is not yet ready to commit to
regular use of a DMT

a. True
b. False
8. In discussing risk acceptance with a patient in regard to a
new MS therapy, the MS nurse should always:

a. recognize that younger people are more open to accepting
risk
b. take into account the patient's level of health literacy
c. try to play down some of the least-likely, serious risks of
DMTs
d. encourage the patient that it's worth taking on some greater
health risks for better disease control

3. Electrocardiogram (ECG) and heart rate monitoring are
part of the safety monitoring protocol for:

a. fingolimod (Gilenya)
b. natalizumab (Tysabri)
c. alemtuzumab (Lemtrada)
d. teriflunomide (Aubagio)

9. Research about medication use in general shows that
patients:

4. Monthly liver function testing is recommended for
patients receiving which of the following DMTs?

a. underestimate common risks
b. overestimate serious risks
c. have an accurate view of how adverse effects may impact
their health
d. both (a) and (b) above

a. glatiramer acetate (Copaxone)
b. interferon beta 1b (Betaseron)
c. dimethyl fumarate (Tecfidera)
d. teriflunomide (Aubagio)

10. Potential adverse effects of MS DMTs:

5. Among patients receiving a DMT, complete blood count
(CBC) is recommended:

a. are well understood based on pre-approval clinical trial data
b. may not become apparent until after several years of
postmarketing use
c. are usually outweighed by the efficacy potential of the drug
d. can always be detected early through monitoring

a. mainly for those on an immunosuppressive agent such as
alemtuzumab
b. only for those receiving an interferon
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Counseling Points Multiple Sclerosis - Spring 2015

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