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Multiple Sclerosis

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Overview

   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.

Details

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.

Authors

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.

ACPE Universal Activity Number: 428-0000-08-001-H01-P


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

Chief Editor and CE Administrator


Terry M. Baker, PharmD

Managing Editor


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

Richard Ron Finley, B.S. Pharm.,R.Ph.
Clinical Pharmacist (volunteer faculty)
University of California, San Francisco (UCSF) Memory and Aging Center
Lecturer (Emeritus) UCSF, Department of Clinical Pharmacy
Health Sciences Clinical Professor, UCSF School of Pharmacy
San Francisco, CA

Consultant Pharmacist
Ray Dolby Brain Health Center, Sutter Health/CPMC
San Francisco, CA

Consult Pharmacist Aging and Adult Health Services
San Francisco Health Department
San Francisco, 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

Helen Berlie, Pharm.D. CDE, BCACP
Clinical Assistant Professor, Pharmacy Practice
Wayne State University
Detroit, MI

Ambulatory Care Specialist - Diabetes
Health Centers Detroit Medical Group
Detroit, MI

Senior Editorial Advisor


Gerard Hatheway, PharmD, PhD

Editorial Advisors


Belinda M. Danielson, RPh
Christopher M. DeSoto, PharmD
Angie S. Graham, 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.

Technical Specifications

Hardware requirements

Any hardware that supports Microsoft Windows, Apple Mac OS, iOS, or Android, and meets the software requirements.

Software requirements

Browser that supports TLS 1.1 + and PDF files.

This includes Microsoft Internet Explorer 11, Google Chrome 38, Google Android OS 5.0 Browser, Apple Safari (version 7 for desktop, 5 for mobile), Mozilla Firefox 27, newer versions of these browsers, as well as some earlier versions that may require additional configuration.

Adobe Acrobat Reader is recommended, and is required for some browsers.

Note: TLS 1.1 and 1.2 support is required for browser security. Click here for TLS browser support details.

Internet Connectivity

Required. Broadband recommended. (T1, DSL, Cable, G4 or higher.)

Contact Us

Exam Processing Inquiries

The Rx Consultant
rxmail@rxconsultant.com
1-800-798-3353

Educational Content Inquiries

The Rx Consultant
editor@rxconsultant.com
1-800-798-3353

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