MEDICATION TEACHING
Glatiramer Injections:
Self-limiting reaction of chest tightness, palpitations, panic and anxiousness that may last 30 sec to 30 min. Refrigerate medication, subcutaneous administration only, rotate injection site.
Interferon Injections:
Apply ice or cortisone cream before injection, rotate sites in order to reduce inflammation and skin irritation. Flulike symptoms following each injection and can be managed with analgesics and antihistamines. Other common side-effects such as GI symptoms, join aches, dizziness, depression or suicidal thoughts.
Steroids:
Common side-effects: Na+ and fluids retention, hypertension, gastric ulcers, weakness, hypokalemia, mood changes, impaired wound healing and masking of infections. Take the medication with food to prevent gastric irritation. Avoid aspirin, indomethacin, caffeine or other GI irritants. Monitor for tarry stools for occult blood. Tapper off the medication rather than stop abruptly to prevent adrenal crisis. Monitor glucose for hyperglycemia and follow with medical provider in order to control BG.
Antispasmotics/muscle relaxants:
Common side-effects: drowsiness, dizziness, fatigue and nausea and other GI symptoms, photosensitivity (with dantrolene). Drowsiness is usually transient. Avoid alcohol due to additive CNS depression effect. Baclofen can also rise BG (additional measures to control BG might needed). If taking dantrolene, monitor for fewer, jaundice, dark urine, clay-colored stools and itching due to hepatitis development.
Smooth muscle stimulants (bethanechol chloride):
Side-effects: hypotension, diarrhea, abdominal crumps, urinary urgency and bronchoconstriction. Take the drug on empty stomach to avoid nausea. Watch for orthostatic hypotention.
Smooth muscle relaxants (tolteradine)
Side-effects: dryness of the mouth, blurred vision, constipation, palpitation, decreased sweating, urinary retention or overflow incontinence.
Mitoxantrone: Patient need to be evaluated for normal cardiac function before starting the drug. This medication can also decrease WBCs, so patient would be prone to infections. Urine may be blue or green for about 24 hr. Medication has a lifetime cumulative dose restriction to limit toxicities.
