MULTIPLE SCLEROSIS (MS)

What is MS?

It is an Auto Immune Disease which is when the body starts to

destroy itself.
It is a life-long disease with no cure.
In MS, the body attacks and destroys the fatty tissue called myelin
that insulates an axon/nerve, and is called demyelination.
If damage is severe it can also destroy the nerve/axon itself.
MS affects the central nervous system and inflames the white matter
in the brain which creates plaques. Plaques block a signal from being
passed from the body to the spinal cord and brain.
MS was first described in 1421 but wasnt considered a disease until
1849.
More prevalent in women of northern European descent.

What is MS? (cont.)

Types of MS

Primary-progressive MS (PPMS)

Slow onset but continuously worsening condition

Progressive-relapsing MS (PRMS)
Steady worsening upon onset
Rarest form

Relapsing-remitting MS (RRMS)
Symptoms followed by partial or complete recovery
Symptoms may be inactive for months or years at a time

Secondary-progressive MS (SPMS)

Occasional relapses but symptoms remain constant, no

remission

Signs and Symptoms of MS

Vision problems
Numbness
Difficulty walking
Fatigue
Depression
Emotional changes
Vertigo & dizziness
Sexual dysfunction

Coordination
problems
Balance problems
Pain
Changes in
cognitive function
Bowel/bladder
dysfunction
Spasticity

FDA Approved MS Medications

Therapi
es

Administration

Class

Avonex

IM, once a week

Interferon beta-1a
(earliest)

Betaser
on

SC, every other day

Interferon beta-1b

Copaxo
ne

SC, QDAY

Glatiramer acetate

Rebif

SC, three times a week

Interferon beta-1a

Gilenya

PO, QDAY

Fingolimod (latest and

greatest)

Tysabri

IV, monthly at treatment Natalizumab

center
Therapeutic classification:
Immunomodulators

Method of Action

The exact method of action with MS medications are

unknown.
Main goals are to inhibit leukocyte production and inhibit
T-cell migration.

Side Effects of MS Medications

Local injection site irritation/reactions

Flu like symptoms
Rise in liver enzymes
Decreased white cell count and platelets
Opportunistic infections
Depression
Progressive multifocal leukoencephalopathy (PML)
Sexual dysfunction
Cognitive dysfunction

Nursing Process

There are no specific tests that can detect MS until the

patient is already symptomatic.
All of the medications used in treating MS highly stress
assessing the patient for depression and signs of suicidal
planning/action.