Patient Care and Monitoring

1. Once diagnosed, work with the patient to select either a ß-interferon or glatiramer acetate, considering:

• Route of administration

• Frequency of administration

• Adverse-effect profile and other concerns (e.g., neutralizing antibodies and concomitant depression)

2. Obtain the required baseline laboratory studies (Table 29-6).

3. Educate the patient regarding self-injection (Table 29-5).

4. Assess the patient for symptomatic treatment needs.

5. Initiate needed symptomatic treatments.

6. Refer the patient to the National MS Society for information, newsletters, and local support groups (

7. Instruct the patient to contact the clinician for any sudden changes in symptoms that may suggest a relapse.

8. Monitor the patient for efficacy and adverse effects of disease-modifying and symptomatic therapies every 3 months for the first year and every 6 months thereafter and as required for selected therapy (Table 29-6).

9. Treat any relapses with methylprednisolone IV or prednisone orally.

Abbreviations Introduced in This Chapter

Ab& Autoantibodies

ALT Alanine a mi 110 transferase

A PC A nt igcn -p rcscii ting eel I

CAM Celi ular ad hesio ¡1 molec u le

CSF Cere bio spina I Quid

E DSS Ex panded Disabi 1 i i y St at u s Seale

HHV-6 Human herpes virus 6

II, Interlcukin

LT Lymphotoxin

M HC M ajo r ti i stocom patibility complex

MMP ¿Matrix metalloprotelnase

MS Multiple sclerosis

MSFC Multiple Sclerosis Fu net tonal Composite

M UGA Mult i pie gated ac qu isition

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