Therapeutics - Multiple Sclerosis Flashcards
multiple sclerosis is a _______ disease of the CNS
demyelinating
true or false
women and men are affected equally by MS
false - women more than men
true or false
the age of onset for MS is old
FALSE - young
20-30ish
true or false
MS DOES affect life expectancy
true
cause of MS
not really known
potentially low levels of vitamin D – immune system stimulates MS (infection)
may be genetic, increased risk in smokers…
the first MS attack is called what
CIS — clinically isolated syndrome
most common clinical pattern of MS
RRMS
relapsing-remitting MS
in which stage of MS are drugs MOST EFFECTIVE
relapsing-remitting MS
20% of relapsing-remitting MS goes on to….
secondary progressive MS (SPMS)
disease progression with our without relapses
what is primary progressive MS
are drugs effective in this stage?
rare – the disease just keeps getting worse right from the beginning
only one drug has been shown to be effective in this stage
diagnosis criteria for MS
2 attacks + MRI
the 2 attacks must be separated by over a month, and also be in different areas of the CNS
the attacks must last at least 24 hours
there must be no other explanation for these attacks!! (ie - brain tumor, stroke, etc)
what is the most sensitive, non-invasive way of imaging the brain and spinal cord and is the preferred method to DIAGNOSE MS?
MRI
what to look for in an MRI to diagnose MS
look for plaques
initial MS symptoms
difficulty walking, fatigue, pain, abnormal sensations (pins and needles)
differentiate between primary, secondary, and tertiary MS symptoms
primary - direct result of dymyelination
secondary - complications BC OF the primary symptoms
tertiary - social/psychological complications
is depression a primary secondary or tertiary MS symptom
may be considered all 3
true or false
treatment for MS is not very effective
false - it is pretty effective, just very expensive
true or false
treatment options for MS are VERY individual-based
true
***she will not ask us to choose a med on the test!
dont really have to mem what is used when
the med options for MS are divided into:
highly effective
moderately effective
modestly effective
explain what should be used first, and when treatment should be switched
start with a highly effective agent
switch if there’s a suboptimal response, more than 1 relapse, OR toxicity/safety issue
how are the interferons administered
SUBQ or IM - patients can give to themselves
when are interferons contraindicated
in severe depression – bc an AE is depression
name some side effects of interferons
injection site reactions
flu-like symptoms
depression
high LFT
patient education for interferons
take ibuprofen or tylenol before injection and every 4 hours prn to lessen flu like symptoms
take at night to “sleep off” any symptoms
rotate injection site
bring syringe to body temp before injecting
use ice to minimize pain at the sight
