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INTRODUCTION

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interferon beta-1b (in-ter-feer-on bay-ta won-bee)

Betaseron

Classification

Therapeutic: anti–multiple sclerosis agents, immune modifiers

Pharmacologic: interferons

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Indications
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Relapsing forms of multiple sclerosis (MS). MS patients who have experienced a first clinical episode and have MRI features consistent with the disease.

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Action
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Antiviral and immunoregulatory properties produced by interacting with specific receptor sites on cell surfaces may explain beneficial effects. Produced by recombinant DNA technology. Therapeutic Effects: Reduce incidence of relapse (neurologic dysfunction) and slowing of physical disability.

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Adverse Reactions/Side Effects
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CNS: depression, headache, incoordination, insomnia, suicidal ideation. Resp: dyspnea. CV: edema, chest pain, hypertension. GI: abdominal pain, constipation, nausea, vomiting, autoimmune hepatitis, elevated liver function studies. GU: urgency, erectile dysfunction. Derm: rash. Endo: menstrual disorders, hyperthyroidism, hypothyroidism, menorrhagia, spontaneous abortion. Hemat: neutropenia, anemia, thrombocytopenia. Local: injection-site reactions, injection site necrosis. MS: myalgia, muscle spasm. Misc: allergic reactions, including anaphylaxis, chills, fever, flu-like symptoms, pain.

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PHYSICAL THERAPY IMPLICATIONS

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  • Monitor signs of allergic reactions and anaphylaxis, including pulmonary symptoms (tightness in the throat and chest, wheezing, cough, dyspnea), or skin reactions (rash, pruritus, urticaria, dermatitis). Notify physician or nursing staff immediately if these reactions occur.

  • Monitor signs of neutropenia (fever, sore throat, signs of infection), thrombocytopenia (bruising, nose bleeds, bleeding gums), or unusual weakness and fatigue that might be due to anemia. Report these signs to the physician immediately.

  • Periodically assess balance, coordination, spasticity, and other aspects of neuromuscular function to help document this drug's effectiveness in reducing MS exacerbations.

  • Monitor personality changes, including depression and increased thoughts of suicide. Notify physician if these changes become problematic.

  • Assess blood pressure (BP) and compare to normal values (See Appendix F). Report a sustained increase in BP (hypertension).

  • Assess peripheral edema using girth measurements, volume displacement, and measurement of pitting edema (See Appendix N). Report increased swelling in feet and ankles or a sudden increase in body weight due to fluid retention.

  • Monitor any chest pain or difficult/labored breathing. Report prolonged or severe cardiopulmonary problems to the physician, especially if these problems are exacerbated by exercise.

  • Assess any muscle pain or spasms to rule out musculoskeletal pathology; that is, try to determine if pain is drug induced rather than caused by anatomic or biomechanical problems.

  • Monitor and report any increase or decrease in metabolism that might indicate thyroid disorders. Signs of hyperthyroidism include tachycardia, nervousness, heat intolerance, weight loss, and muscle wasting. Hypothyroidism is typically indicated by bradycardia, lethargy, cold intolerance, weight gain, and muscle weakness.

  • Assess dizziness that might affect gait, balance, and other functional activities (See Appendix C). Report balance problems and functional limitations to the physician and nursing staff, and caution the patient and family/caregivers to guard against falls and ...

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