Multiple Sclerosis Flashcards
What is the basic physiologic problem that causes Multiple Sclerosis?
An autoimmune, inflammatory, and chronic progressive disease that attacks the myelin sheath and causes neuronal loss in the brain and spinal cord
What change occurs with demyelination of the neuron?
Nerve conduction slows down
Neuroglial tissue in the white matter of the CNS increases and forms hard, yellow plaques of scar tissue.
Proliferation of the neuroglial tissue is called gliosis
What are the three pathologic processes associated with MS?
Chronic inflammation
Demyelination
Gliosis
What are the three different types of MS?
Relapsing–Remitting (RRMS)
Symptoms get?
During a relapse?
Then?
Symptoms get worse for a while and then get better.
During a relapse, they might feel new symptoms or old ones might come back stronger.
Then, after some time, those symptoms improve or even disappear for a while.
Most common form of MS
Secondary Progressive (SPMS)
Symptoms gradually?
Shifts to?
Symptoms gradually worsen over time after an initial phase of relapsing-remitting MS (RRMS).
Shifts to a steady worsening of symptoms.
There may still be occasional relapses, but overall, neurological function declines without clear periods of recovery.
Primary Progressive (PPMS)
No?
Symptoms?
No back and forth
Symptoms gradually worsen without relapses
Clinical manifestations of MS? 5
Vision problems
Difficulty with Speech and swallowing
Muscle strength/weakness
Balance and coordination
Vibratory sensation
What are the 2 INITIAL symptoms associated with MS?
Vision problems (caused by optic neuritis)
Sensory impairment (paresthesia)
Paresthesia is an abnormal feeling of tingling, burning, pricking, numbness, itching, or skin crawling that occurs without an outside cause
What are the clinical manifestations associated with MS after initial episode? 3
Most common problem for people with MS?
What new symptoms may occur?
Blurred vision/diplopia
Emotional lability
Dysphagia
Fatigue!!
Head stuff
Why are corticosteroids used to treat/manage MS?
Diagnostic test for MS?
Usually given for acute relapses to quickly decrease inflammation
Anti-inflammatory
Immunosuppressant
MRI!
Vumerity
Used for?
What kind of capsules?
No?
Used for relapsing forms of MS
Time-released capsules
No alcohol ingestion at the same time med is taken
Decreases absorption of Vumerity
Side effects of Vumerity? 5
AHFGD
What is a serious side effect?
Angioedema
Hepatotoxicity
Flushing
GI Distress
Decreased WBC
PML: Progressive Multifocal; leukoencephalopathy): Rare brain infection
Weakness on one side
Vision problems
Confusion
Personality changes
Kesimpta
Used for?
Increased risk for?
3 more side effects?
Whats not recommended during treatment?
Used for relapsing-remitting
-Increased risk for infection, esp, resp inf
-Headache
-PML
-Can reactivate Hepatitis B
Live vaccines are not recommended during treatment!
Lemtrada
Used for patients with?
Immunosuppressant used to treat relapsing forms of MS
Used for patients with highly active disease who have already tried other treatments
For patients with severe disease who have had 2 or more relapses in one year
Lemtrada (THINI)
given as?
side effetcs? 5
Given as an infusion
Thrombocytopenia
Hypo or Hyperthyroidism
Increased risk for infection
Nephrotoxicity
Insomnia
Ocrevua (RRPI)
Used for what MS?
Target?
Side effects? 4
Only approved drug for Primary Progressive MS
Targets B cells to slow progression
Respiratory tract infections
Reactivated viral infections
PML
Immunosuppression
What are two primary non-pharmacologic interventions to address MS?
Good nutrition
Adequate rest and relaxation
