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Multiple Sclerosis

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   Multiple sclerosis (MS), a chronic, inflammatory disease of the CNS, is not a rare condition. In the United States, MS ranks as the second most common cause of neurological disability and the leading cause of non-traumatic disability in young adults.

   Before the release of the first disease-modifying drug (interferon beta 1b Betaseron) in 1993, the available medications for MS targeted only the relief of symptoms such as urinary urgency. Today, a total of 6 disease modifying drugs (DMD) are available. These drugs reduce the frequency of relapse by about one third and are believed to slow disease progression. Unfortunately, DMDs do not cure MS and their impact on long-term disability remains to be seen. Current research suggests that neurological damage early in the course of MS results in long-term impairment. Consequently, many experts recommend early initiation of treatment with DMDs.

   This issue provides an overview of MS and an update on the drugs currently used to manage the disease, including those that may prevent or delay disease progression and medications that treat specific symptoms.


Publication Date: 01/01/2008
Expiration Date: 02/01/2011
CE Credit: 1.5 (0.15 CEU)
Type of Activity: Knowledge-based

This program was developed by The Rx Consultant and published by Continuing Education Network, Inc. The Rx Consultant accepts no advertising or financial support from the pharmaceutical industry and is funded solely by the purchase of programs. The Rx Consultant is dedicated to providing unbiased, balanced information to health care practitioners.

Programs developed by The Rx Consultant are written by health care providers with expertise in the topic area, peer-reviewed, extensively edited, and fact-checked. This development process was created to insure that every program presents information that is current, accurate, relevant to "real world" health care providers, and written in an easy reading, "plain English" style.


Ellen Whipple Guthrie, Pharm.D., Assistant Clinical Professor, University of Georgia College of Pharmacy; Pediatric Pharmacist, Children's Healthcare of Atlanta; and Medical Advisor, Multiple Sclerosis Foundation. Dr. Guthrie has been directly working with MS patients for 8 years.

Disclosure Statement

Dr. Guthrie owns stock (< 200 shares) in Teva Pharmaceutical Industries, Ltd., a manufacturer of Novantrone®

Guest Editorial Advisor

Jacci Bainbridge, Pharm.D.

Target Audience

This accredited program is targeted to pharmacists and nurses.

Goals & Objectives

At the conclusion of this program, participants will be able to:

    • Describe the pathophysiology, suggestive symptoms, and general types of multiple sclerosis.
    • Discuss the approach to MS management, including the treatment of acute attacks, altering the natural course of the disease, and managing the symptomatic problems associated with MS.
    • Summarize the potential benefits and safety issues with the use of the interferon-ß products (Avonex®, Rebif®, Betaseron®) and glatiramer acetate (Copaxone®). Discuss the potentially serious side effects of natalizumab (Tysabri®) and mitoxantrone (Novantrone®).
    • Provide patients with injection technique advice for each DMD.

    Accreditation Statements

    The Rx Consultant is a publication of Continuing Education Network, Inc. Continuing Education Network, Inc. is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education as a provider of continuing pharmacy education.

    Continuing Education Network is approved by the California Board of Registered Nursing, Provider Number CEP 13118. Programs approved by CA BRN are accepted by most State Boards of Nursing.

Exam & Credit Statement Procedures

Upon successful completion of this program and the post test (70%), 1.5 hours of continuing education credit will be awarded. To receive credit and your exam score, please complete the exam questions and program evaluation.

Editorial and Review Board

Editor and CE Administrator

Terry M. Baker, PharmD

Associate Editor and CE Coordinator

Tracy Farnen, PharmD

Associate Editors

James Chan, PharmD, PhD
Pharmacy Quality and Outcomes Coordinator
Kaiser Permanente
Oakland, CA

Associate Clinical Professor
School of Pharmacy
University of California San Francisco
San Francisco, CA

Ron Finley, RPh
Department of Clinical Pharmacy
University of California San Francisco
San Francisco, CA

Associate Member of the UCSF Memory and Aging Center
Alzheimer's Research Center

Consultant Pharmacist to the Institute on Aging-On Lok Senior Health
Institute on Aging Alzheimer's Day Care Center

Angie S. Graham, PharmD
Drug Information Coordinator
Stanford Hospital and Clinics
Stanford University Medical Center
Stanford, CA

Julio R. Lopez, PharmD, FCSHP
Chief of Pharmacy Service
VA Northern California Health Care System

Adjunct Clinical Professor
College of Pharmacy
Touro University
Vallejo, CA

Assistant Clinical Professor
School of Pharmacy
University of California, San Francisco
San Francisco, CA

Adjunct Professor
Thomas J. Long School of Pharmacy
University of the Pacific
Stockton, CA

Visiting Associate Professor and Lecturer
Nursing School
Samuel Merritt University
Oakland, CA

Pamela Mausner, MD

Joshua J. Neumiller, PharmD, CDE, CGP, FASCP
Assistant Professor
Department of Pharmacotherapy
College of Pharmacy
Washington State University
Elder Services of Spokane
Spokane, WA

Candy Tsourounis, PharmD
Professor of Clinical Pharmacy
Medication Outcomes Center
Department of Clinical Pharmacy
School of Pharmacy
University of California, San Francisco
San Francisco, CA

Senior Editorial Advisor

Gerard Hatheway, PharmD, PhD

Editorial Advisors

Jocelyn Chan, PharmD
Belinda M. Danielson, RPh
Christopher M. DeSoto, PharmD
Cynthia Chan Huang, PharmD, MBA
Fred Plageman, PharmD

Editorial Advisor and Clinical Practice Consultant for Nurse Practitioners

Emily K. Meuleman, RN, C, MS

About the Rx Consultant

The Rx Consultant is a monthly publication dedicated to providing health care professionals with the information they need to educate patients about drugs and manage drug therapy. The reader is responsible for confirming the information presented here and interpreting it in relation to each patient's specific situation before utilizing the information.

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