Multiple Sclerosis Treatment

Acute attack = shorten duration

Disease-Modifying therapy = decrease progression

Symptomatic Therapy = Maintain patient QOL
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Terms in this set (17)
Acute attack = shorten duration

Disease-Modifying therapy = decrease progression

Symptomatic Therapy = Maintain patient QOL
What are the three treatment categories?
Mild = do not treat (does not effect function)

Functional ability = High Dose corticosteroids for 3-5 days (helps decrease edema in areas or demyelination --> does not affect progression.
Treatment of Acute Exacerbations:
Manipulate immune system

Decrease frequency and severity
Slow progression

CANNOT restore neurological function
Goals of disease modifying therapy:
Escalating Therapy (Injectables or oral)
OR
Induction Therapy (Infused mainly)
First-Line Therapy Injectables

Types
**
Know which are first line / second / Salvage therapy
Escalating Therapy

Betaseron and Extavia

SQ QoD
Disease-Modifying Drugs

Interferon-B1b

Brand
Administer
Avonex and Rebif

Avonex: IM once weekly
Rebif: SQ 3x/week
Interferon-B1a

Brand
Administer
Plegridy

SQ once every to weeks

Pegalated
Peginterferon-B1a

Brand
Administer
Upper, outer, thigh

all others can be abdomen, thigh, back of arm, buttocks
Where does Avonex have to be administered?
injection site redness, swelling
OR
Necrosis
Common AE's for interferons?
Beta-1-Bs (Betaseron / Extavia) Using Auto-Injector Proper injection technique Hydrocortisone cream to decrease swelling Ice can decrease pain and rednessInjection site reactions are more common with.. How to reduce risk?Flu-like symptoms (typically 24 hours after injection) Hydration NSAIDs DEPRESSION, and liver dysfunctionOther common AE's for interferons?CBC / LFT / ThyroidWhat monitoring should be done for interferons?interferons should be stopped Peginterferon should be stopped prior to conceptionInterferons and pregnancy....Fewer rections Fewer injectionsAdvantage of Avonex/Plegridyinterferons SQ daily or 3 times weekly Injection site reactionsGlatiramer acetate Similar to... Administration AE'sdoes not cause flu like symptoms or depression transient reaction of chest tightness, flushing, dyspnea following injection No monitor in clinical practice Safe in PregnancyGlatiramer considerations