A patient with multiple sclerosis is to begin treatment with ...

[armygirl]

A patient with multiple sclerosis is to begin treatment with interferon beta. The patient comes to the clinic to have pretreatment laboratory tests. Which statement by the patient indicates a need for further teaching about these tests?
 
  a. After the first year of treatment, I will need once yearly blood work.
  b. I will need to have lab tests done every 3 months for the first year.
  c. If my liver function tests are abnormal, I will need to stop using this drug.
  d. These lab tests will measure liver and bone marrow function.

Question 2

A patient administers interferon beta-1a SQ (Rebif) 22 mcg/0.5 mL three times each week.
 
  The patient calls the nurse to report unrelieved itching and erythema at the injection site, despite the use of topical hydrocortisone for several weeks. What will the nurse tell this patient to do?
  a. Apply ice to the injection site before and after the injection.
  b. Ask the provider to reduce the dose of interferon beta to 8.8 mcg/0.2 mL.
  c. Discuss using a prescription-strength hydrocortisone product with the provider.
  d. Take oral diphenhydramine (Benadryl).

[bassamabas]

Answer to Question 1

ANS: A
Patients treated with interferon beta require evaluation of bone marrow function with CBCs and of liver function with liver function tests (LFTs) at the beginning of therapy for baseline, every 3 months for a year, and then every 6 months thereafter. Abnormal LFTs warrant discontinuation of the drug.

Answer to Question 2

ANS: D
Oral diphenhydramine can help reduce itching and erythema. Ice is used to control pain and should be used before the injection; warm, moist compresses are used after the injection. Reducing the dose of interferon will not reduce the local reaction. Continuous use of topical steroids is not recommended because of the risk of skin damage.

[armygirl]

Excellent

[Jsherida]

TYSM