CSP CSP - Certified Specialty Pharmacist Clinical Management: Neurology and Rare Disease Questions and Answers 1

Question 1

Which disease-modifying therapy for multiple sclerosis (MS) requires REMS program enrollment due to risks of progressive multifocal leukoencephalopathy (PML)?

Accepted Answer

Natalizumab (Tysabri)

Answer

Natalizumab (Tysabri) carries a REMS requirement called TOUCH because of the risk of PML, a potentially fatal brain infection caused by JC virus reactivation.

Question 2

A patient with spinal muscular atrophy (SMA) is prescribed nusinersen (Spinraza). What is a key specialty pharmacy role in managing this therapy?

Accepted Answer

Coordinating benefits, site-of-care logistics, and patient support for this high-cost intrathecal therapy

Answer

Nusinersen is an intrathecal injection administered by a neurologist; the specialty pharmacy's role centers on benefits investigation, authorization, site-of-care coordination, and patient/caregiver support.

Question 3

Which monitoring parameter is MOST critical for patients on alemtuzumab (Lemtrada) for multiple sclerosis?

Accepted Answer

Thyroid function tests, complete blood count, and urinalysis monthly for 48 months after last dose

Answer

Alemtuzumab carries risks of serious autoimmune conditions, including thyroid disorders, immune thrombocytopenia, and nephropathy, requiring monthly monitoring of thyroid function, CBC, and urinalysis for 4 years post-treatment.

Question 4

For a patient with Gaucher disease type 1 starting enzyme replacement therapy (ERT) with imiglucerase (Cerezyme), what is the MOST important pharmacist counseling point regarding administration?

Accepted Answer

Infusion reactions may occur, and premedication and close monitoring during infusions are recommended

Answer

Infusion-related reactions are the most common adverse effects of imiglucerase; patients should be informed about symptoms and the importance of premedication and monitoring at the infusion site.

Question 5

A CSP is counseling a patient newly prescribed fingolimod (Gilenya) for relapsing MS. Which assessment must be completed BEFORE the first dose?

Accepted Answer

Cardiac evaluation including ECG and first-dose observation for bradycardia

Answer

Fingolimod causes bradycardia and AV block with the first dose; an ECG is required beforehand and patients must be observed for at least 6 hours after the first dose for cardiac effects.

CSP - Certified Specialty Pharmacist Practice Test

CSP - Certified Specialty Pharmacist Practice Test

CSP CSP - Certified Specialty Pharmacist Clinical Management: Neurology and Rare Disease Questions and Answers 1