Question

You are a nurse in an inpatient acute care rehabilitation center. Your patient is a 55-year-old female who has been diagnosed with MS. She is determined to learn as much as she can about the disease and the treatments available. The following are her questions: My doctor just prescribed interferon Beta. How does this medication work to reduce my symptoms of MS, like fatigue? What side effects can I expect from this medication? Is there any precautions I should like while on this drug? This patient comes back to clinic and has raised ALT/AST. The provider changes her medication to Glatamir. How is this different from Interferon Beta? Why was this medication chosen to replace Interferon Beta?

Answer 1

• Interferon Beta is administered to prevent relapses of Multiple Sclerosis.Our immune system has the ability to protect our body against infections. In Multiple Sclerosis,person's immune system loses this ability, thereby attacking the nerves of your brain and spinal cord by mistake.Thus the myelin sheath (covering the nerves) becomes inflamed and finally would get damaged.Our body also produces interferons to slow down the infection.Likewise, administration of Interferon Beta,controls secretion of anti-inflammatory cytokines,supresses T cell activation leading to repair of the damaged nerve cells which will eventually reduce the symptoms.
• The most common side effects are--Flu-like symptoms including headaches,chills,fever,muscle pain, joint,arm and leg pain,Mood changes,depression,allergic reactions on face,lips and tongues and dyspnea Injection site reactions like red,hard and itchy skin .Others are decreased peripheral blood count, liver problems,kidney problems,formation of blood clots ,autoimmune diseases,loss of fat in areas under the skin.
• Precautions

1. Report immediately to the physician if symptoms of depression,suicidal tendency or psychosis arise.
2. Monitor for signs of liver injury.
3. Stop the drug if allergic reactions occur.
4. If the patient has a history of congestive heart failure,continuous monitoring of the heart will be required during the treatment with interferon beta.
5. Check blood counts regularly to reduce the risk of pancytopenia and thrombocytopenia.
6. Discontinue the drug if seizures occur.
7. Interferon beta should not be taken during pregnancy.

• Glatiramer is a man made protein which prevents T cells from attacking myelin but interferon beta are chemical messengers that prevent body from attacking the central nervous system.
• Glatiramer was chosen over interferon beta as the ALT/ AST were raised which shows hepato toxicity. Continous ALT elevations due to chronic hepatitis need discontinuation of interferon beta.