most common form; with each relapse, recovery is complete but residual deficits accumulate over time -
relapsing-remitting
meds for fatigue (4) - amantadine (symmetrel)
pemoline (cyclert)
methylphenidate (ritalin, concerta)
modafinil (provigil)
MS affects - 20-40 year old women
disease progression with or without relapses - secondary progressive
disabling symptoms steadily increase with rare plateaus and temporary improvement - primary
progressive
least common; relapses with continuous disabling progression between exacerbations -
progressive relapsing
diagnostic tests for MS (4) - exam
MRI
EPS (evoked potential studies)
CSF (identifies presence of oligoclonal banding)
disease-modifying meds - A - Avonex (IM once per week) OR Rebif (SQ 3 times per week)
B - Betaseron (SQ every other day)
C - Copaxone (SQ daily)
, disease-modifying med goals (3) - decrease frequency of relapse
decrease duration of relapse
decrease plaques on MRI
BRM side effects (5) - flu-like - take at night
depression/suicidal tendencies/anxiety
leukopenia/thrombocytopenia
elevated liver enzymes
hypersensitivity at injection site
copaxone side effect - transient chest pain
things to monitor when on BRMs (4) - liver enzymes
CBC/platelets
injection site
emotional changes
Multiple Sclerosis is an ___ mediated, progressive ___ disease of the CNS that results in impaired ___
____ - immune, demyelinating, nerve transmission
cytoxan and methotrexate are ___ agents - antineoplastic
immuran and sandimmune are ____ drugs - immunosuppressant
anticonvulsant drug for spasticity - klonopin
med for acute relapse...dosage - IV methylprednisone 1g daily for 3-5 days with or without PO
prednisone taper
OR
ACTH - stimulates release of cortisol; 25-60 mg over 2-4 weeks