MS Flashcards
1
Q
Overview of disease
A
- chronic inflammatory autoimmune disorder that damages the myelin sheath of CNS neurons
- Myelin loss: creates decreased nerve conduction: slows or blocks axonal conduction
- affects 20-40 yo females
2
Q
symptoms of MS
A
Motor-control spasticity Coordination problems Difficulty walking Balance problems Fatigue Pain Vision problems Changes in cognitive function Numbness Bowel/bladder dysfunction Depression Emotional changes Vertigo & Dizziness Changes in sexual function
3
Q
Symptom management
A
Spasticity - Baclofen > Dantrium Depression - Antidepressants Tremors - Beta blockers Neuropathic pain - Antiseizure Bladder dysfunction - Anticholinergics Acute exacerbations - Corticosteroids
4
Q
Interferon beta (immunomodulators)
A
- Avonex, Betaseron, Extavia
- MOA: naturally occurring glycoproteins produced in response to viral and other biologic inducers, inhibits migration of proinflammatory leukocytes across BBB, suppresses T-helper cell activity
-used for relapsing forms of MS
SE: flu-like symptoms, hepatotoxicity, myelosuppresion, injection-site reaction, depression
decrease severity of attacks, number and size of MRI lesions, and delays progression of disability
5
Q
Motixantrone (immunosuppressants)
A
- suppresses production of immune system cells= decreased destruction of myelin
- clinical use: cancer, MS: worsening relapsing-remitting, secondary progressive, progressive-relapsing
SE: myelosuppression, cardiotoxicity, irreversible hair loss, GI irritation
reserved for patientss who cannot be treated with safer agents
6
Q
Antispastics/antiepileptics
A
- baclofen, tizanidine, diazepam
MOA: capable of inhibiting both monosynaptic and polysynaptic reflexes at the spinal level, possibly by hyperpolarization of afferent terminals
Clinical Considerations: fewer side effects, better relief of spasticity, usually more effective on the LE, requires commited patient, pump must be filled every 3 months
