Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NUR 406 > Multiple Sclerosis > Flashcards

Multiple Sclerosis Flashcards

1
Q

what is MS

A

chronic inflammatory autoimmune disorder
- potentially disabling of the brain and spinal cord

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what are the characteristics of MS

A
  • inflammation
  • demyelination
  • scar development (gliosis, plaque formation)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is the cause of MS

A

unknown
- maybe triggered by infection
- genetic predispostion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what are the known risk factors of MS

A
  • 20-40
  • women
  • moderately cool climate
  • caucasian
  • fam hx
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what are possible risk factors of MS

A
  • smoking
  • vit d def
  • obesity
  • infection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is the patho of MS

A

consistent autoimmune attack against the myelin sheath
- t lymphoctyes migrate to CNS and cross the BBB
- antigen-antibody rxn in the CNS initiates inflammatory response
- axons are demyelinated and plaques/sclerosis form
- axons eventually become destroyed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what cells produce the myelin sheath and are destroyed during the inflammation process?

A

oligodendrocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what happens when there is damage to myelin sheath

A
  • disruption of nerve conduction
  • slows the nerve impulse
  • eventually leads to brain atrophy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

how are the neurons affected during the early stages of MS

A
  • nerve fiber is not affected and impulses are still transmitted
  • may be able to notice some weakness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

how are the neurons affected during the later stages of MS

A
  • axons are destroyed
  • impulses are completely blocked
  • permanent loss of function
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what are the different types of MS course progression

A
  • benign
  • relapsing-remitting
  • primary progressive
  • secondary progressive
  • progressive relapsing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is benign MS

A

exacerbation with a return to baseline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is relapsing remitting MS

A

most common, long periods of remission with occasional exacerbations that can leave permanent deficients
- always coming back a little bit weaker

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is primary progressive MS

A

gra\dual progression of sx without periods of remission

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is secondary progressive MS

A

initial exacerbation with some loss of function but later exacerbations/remission periods become shorter and with inc in deficits

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what is progressive relapsing MS

A

gradual progression of decline with each exacerbation and remission

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what are the clinical manifestations of MS

A

it depends on what area of the CNS is being affected
- ex: numbness, tingling, walking difficulty, pain, fatigue, h/a, dizzy, depression, etc

18
Q

what are sx to monitor in pt with MS

A
  • cognitive problems
  • vision problems
  • depression
  • fatigue
  • pain
  • bowel/bladder
  • weakness
  • sexual issues
  • muscle stiffness/spasms and numbness/tingling
  • walking/balance –> vertigo
19
Q

what is the cure for MS

A

none

20
Q

what is the goal of pharm therapy for MS

A
  • slow disability
  • reduce frequency or relapses
  • reduce new brain lesions
21
Q

what types of drugs are typically used to treat MS

A
  • drugs that modifying the disease process
  • treat an acute relapse
  • manage sx
22
Q

what drugs are used to modify the disease process of MS

A

Avonex: intergeron beta
copaxone: glatiamer acetate
fingolimod
dimethyl fumarate
natalizumab
alemtuzumab
mitoxantrone

23
Q

what is the moa of interferon beta-1a/b

A

inhibit pro inflammatory WBCs from crossing the BBB
* block immune system which helps to dec inflammation*

24
Q

what is the advantage of interferons

A

dec relapse rate by 30%

25
Q

what are the adverse effects of interferons

A
  • flu like rxn
  • liver toxicity
  • bone marrow suppression
  • depression
  • drug interactions
26
Q

what is the moa of glatiramer acetate

A

inc production of anti inflammatory T cells which cross the BBB to suppress inflammation

27
Q

what are the adverse effects of glatiramer acetate

A
  • injection site rxn
  • post injection rxn: flushing, palpitations, chest pain, rash, laryngeal constriction
    – typically transient lasting 15-20 mins and treatment not necessary
28
Q

what is the moa of fingolimod

A

retain lymphocytes in the lymphnode preventing them form crossing the BBB to dec inflammation
- used for RRMS

29
Q

what is the moa of dimethyl fumarate

A

thought to inhibit immune cells and may have antioxidant properties

30
Q

what is the moa of natalizumab

A

prevents circulating T cells from leaving the vasculature and crossing BBB

31
Q

what is natalizumab used for

A

MS and crohn’s

32
Q

what are nursing considerations for natalizumab

A

mono therapy only

33
Q

what are the adverse effects for natalizumab

A
  • most common: headache, fatigue
  • progressive multifocal leukoencephalopathy –> only certain drs can prescribe this drug, risk when combined with steroids
  • hepatoxicity
  • hypersensitivity
34
Q

what is alemtuzumab used for

A

reserved for pts with poor responses to two or more MS medications

35
Q

what is mitoxantrone used for

A

secondary progressive
progressive relapsing
worsening RRMS

36
Q

how do we treat an acute relapse of MS

A
  • high dose glucocorticoid or
  • IV gamma globulin (pts intolerant to glucocorticoids) or
  • ACTH (unable to tolerate steroids, or they haven’t been effective)
  • replace plasma
37
Q

what drugs are used to treat MS pts with urinary frequency and retention

A

anticholinergics
cholinergics

38
Q

what drugs are used to treat MS pts with constipation

A

bulk forming laxatives

39
Q

what drugs are used to treat MS pts with fatigue

A

amantadine

40
Q

what drugs are used to treat MS pts with muscle spasms

A

muscle relaxants

41
Q

what drugs are used to treat MS pts with congnitive dysfunction

A

donepezil

NUR 406 (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions