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 (www.nmss.org).

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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