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LINDSAY PARKS 01463 705062 Multiple SclerosisSpecialist Nurse
THE TEAM • Dr Bethany Jones • Dr Kate Taylor • Dr Barbara Chandler • Dr Eleanor Reid • Louise Duncan • Lindsay & Anne
Aim of the MS Nurses service • Provide timely advice and information • Link with all appropriate services • Highlight the disease
Role of the MS Nurses service • Offer support & guidance to any person with MS • Develop the service • Link with Voluntary & statutory sector • Provide newly diagnosed with info, advice & support • Co ordinate services for people with moderate / severe disability
Role of the MS nurses Services • Enhance liason & support for patients, carers & staff in the community -Home visits • Provide education • Support patients from RR to SP MS • Lead treatment of DMT’s, Tysabri • Provide nurse led clinic’s
MS Nurse • Work closely with – • Local MS branches & Therapy Centres • National MS Society • MS Trust • UKMSSNA • All Health services in Highland (ward 2A)
Key Facts About MS.(from MS TRUST 2011) - There are 100,000 people with MS in the UK and 2.5m in the world. • 50 people a week are diagnosed with MS. • 3-1 Ratio of women to men diagnosed with MS. • MS is the most common cause of disability in young adults. • Only 1in 4 people with MS regularly use a wheelchair.
RELAPSES • An episode of Neurological symptom (caused by inflammation or demylination), that lasts at least 24hrs and is not caused by infection or other cause. That happens at least 30 days after any previous episode began. • New symptoms can appear, or old symptoms re-appear, either gradually or suddenly. • They usually come on over a short period of time- hours or days.
Psuedo-Relapses • Sometimes patients experience a flare-up of symptoms which is not a relapse. e.g Colds, Flu’s, UTI’s, etc can raise body temperature & make symptoms temporarily worse. • Psuedo-relapses should be treated by treating the cause of the fever.
Treating Relapses • Methylprednisolone orally or intravenously, 500mgs a day for 5 days or 1g a day for 3 days. • Stomach cover should be given e.g Omeprazole 20mg daily. • Depending on the nature of the relapse, referral to physiotherapy Rehabilitation can be beneficial also.
Disease Modifying Therapies (DMT’S) • Not a cure for MS. Reduce rate of relapses by a third and severity by a third. • Eligibility: x2 Clinically significant significant relapses in the last 2 Years. Must be able to walk at least 10metres with/without assistance (or 100 Metres without assistance-Copaxone)
Injectable Therapies • Avonex (beta interferon)-Weekly IM Injection • Extavia (beta interferon)-Alternate days sc injection. • Rebif (beta interferon)-Three times a week sc injection. • Copaxone (glactiramer acetate)-daily sc injection
Tysabri- Natalizumab • First Monoclonal antibody licensed in MS. • Tysabri works by binding to adhesion molecules on the immune cell surface and its thought to act by preventing the cells passing into the CNS via the blood brain barrier. (It is a selective adhesion molecule inhibitor)
Tysabri • Studies have shown it to have a 67% reduction in Relapses. • Infused IV in Hospital setting every 4 weeks. • Eligibility: Highly active RRMS, failed to respond to Betaferons. At least one relapse in previous year whilst on therapy, evidence of lesions on MRI. OR. • Rapidly evolving Severe RRMS. (2 or more disabling relapses in one Year and increasing lesions on 2 Consecutive MRI scans).
Tysabri • Risk of PML (Progressive Multifocal leukoencepalophathy. A viral brain infection. • Rare liver problems. • FBC & LFT’s every 4 weeks between each infusion. • Infused in Hospital setting. First 2 infusions in Raigmore then can go out to community hospitals if suitable.
Thankyou. ANY QUESTIONS