MS
What are the 4 MS of MS?
Many Scars
Muscle Spasm
Muscle Stiffness
Myelin Sheath
Symptoms of MS?
- Symptoms: Numbness, tingling, blurred vision, double vision, neuropathic pain, muscle spasms, severe fatigue, emotional changes, depression, incontinence
MS med class: Immunosuppressants meds? SE??? Vaccines?
Mitoxantrone, Dimethyl fumarate
- SE: Bone marrow suppression (Watch for infection and bleeding)
- Cannot receive live vaccines
- Avoid crowds
MS Muscle Relaxant med? and how does it work?
Baclofen
- Relieves spasms, cramping, and tightness
- Improves muscle movement and relieves pain
Interferon Beta SE's?
SE: Depression, dizziness, fatigue, vision problems, neutropenia, hepatitis, muscle spasms, myalgia, arthralgia, flu-like symptoms
More common in Men or Women? What age usually?
Women>men
20s to 40s
Steroid name? How does it work?
Methylprednisolone (Solu-Medrol)
- May improve the symptoms but steroids decrease immune functions
- Work by reducing edema and acute inflammation at the site of the demyelination
MS med class: Monoclonal Antibodies meds?
Alemtuzumab, Natalizumab, Ocrelizumab
MS med class: Synthetic Purine Nucleosides Antimetabolites meds?
Cladribine
What is the common MS drug that has anti-cholinergic SE's?
Baclofen
What type of disease is MS and how does it work?
Autoimmune
- Antibodies attack the myelin sheath of nerve fibers causing lesions known as “plaques”
Diagnosis for MS?
Diagnosis: H/P, MRI (visible plaques), Lumbar puncture (elevated gamma globulin, protein)
MS med class: Sphingosine-1 Phosphate Receptor Modifiers meds?
Fingolimod, Siponimod
MS Teaching: Avoid what?
Avoid triggers: Stress, Sickness, Sepsis, Smoking, Sun (heat exposure)
What are the 2 immunosuppressants?
Mitoxantrone and Dimethyl Fumarate
1st line of treatment?
Immune modulators/DMD’s (Disease Modifying Drugs)
MS med class: Immune Modulators meds?
Interferon Beta, Glatiramer, Teriflunomide
Other 2 MS classes of meds?
Corticosteroids and Muscle Relaxer
Is there a pattern for MS?
No two cases of MS are alike, so drugs are tailored to the classification, disease pattern, and symptom manifestation of the patient
What is Cyclosporine?
- Immunosuppressant often used with organ transplant recipients to prevent organ rejection
- It can cause hyperglycaemia and severe hyperkalemia
- Grapefruit juice needs to be avoided since it causes increased levels of cyclosporine
- Frequent monitoring of BUN, Cr, Mag, K, and LFT's is required
MS onset? Cure?
- Onset is slow
- No cure
- 5 different classifications
Immunomodulator (Interferon-beta): Route? Preg? SE? Freq?
- NO PREGNANCY!
- Can be SQ or IM
- Can be every 2 days, once a week or every 14 days
- SE: Depression, dizziness, fatigue, vision problems, neutropenia, hepatitis, muscle spasms, myalgia, arthralgia, flu-like symptoms
What is IVIG? and what does it do?
Intravenous Immune Globulin
- Strengthens the immune system and lowers the risk of infection in people with weakened immune systems
MS teaching?
- Balance exercise with rest periods
- Promote independence
- Medications: Short term (Steroids), Long term (DMD’s)
MS sheet tips
- Onset is 20 to 40 years old
- Autoimune
- Usually females
- Causes urinary retention, spastic bladder, and constipation
- Weakness may progress to paralysis
- Ataxia, vertigo, and muscle spasticity
- Nystagmus (cross eye), blurred vision, dysphagia (hard swallowing), dysarthria (hard speaking), and diplopia (seeing double)
- Tinnitus and decreased hearing