Neuromuscular and Neurodegenerative Disorders – Bonita Gordon

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Management Strategies for:

• Multiple Sclerosis
• Alzheimer’s Disease
• Myasthenia Gravis
• Parkinson’s Disease
• Guillain-Barré Syndrome
• Amyotrophic Lateral Sclerosis

Neuromuscular & Neurodegenerative Disorders remain the nation’s leading cause of disability. They are devastating and costly. There is a need to provide early diagnosis and apply effective therapies for these disorders. Join expert, Bonita Gordon, MSN, RN, APRN-BC, CNRN, and gain new insights into the pathophysiologic changes, clinical manifestations, and diagnostic studies for each of these disorders. Learn the latest in innovative medications that are geared to slow or stop the disorder progression.

Through an engaging presentation style and enlightening case studies, Bonita will enhance your knowledge regarding current practice issues. The evidence-based content is valuable to all healthcare providers caring for patients with neuromuscular and neurodegenerative disorders.

OUTLINE

Multiple Sclerosis

• Four Classifications of MS
• Look for the Oligoclonal Bands
• ABCs of Medication Management
  • Immunomodulating disease-modifying agents
  • Corticosteroids
  • Antispasmotic
  • Anticholinergic
  • Antiviral
  • CNS stimulant
  • Antiepileptic
  • Antidepressant
  • Beta blocker
  • Natalizumab
• Manage the Symptoms
  • Optic neuritis
  • Fatigue
  • Ataxia

Alzheimer’s Disease Diagnosis

• Staging the Disease
• Disease-Specific Treatment
  • Drug therapy to slow the progression
  • Treatment of behavioral manifestations
• Provide a Therapeutic Environment
  • Participate in activities of daily living
  • Monitor and protect from injury
  • Community resources
  • Caregiver stress

Myasthenia Gravis

• Neuromuscular Junction Disorder
  • Autoimmune process
  • Reduced acetyl-choline receptor sites
• Doing the Edrophonium Test
  • Evaluate response to edrophonium (telsilon)
  • Short-acting anticholinesterase inhibitor
  • Increase neurotransmission
• Pathways to Recovery
  • Medications – anticholinesterase inhibitors, corticosteroids, immunosppressive agents
  • Thymectomy
  • Plasmapheresis or intravenous immunoglobulin

Parkinson’s Disease

• Degeneration of Substantia Nigra
  • Basal ganglia degeneration
  • Deficiency of dopamine
• Know the Symptoms “T-R-A-P”
  • Tremors – resting
  • Rigidity – cogwheel jerking
  • Akinesia – bradykinesia
  • Posture – stooped, shuffling gait
• Treatment Options
  • Medications – dopaminergics, anticholinergics, dopamine agonist, MAO-B inhibitor, COMT inhibitors, antiviral
  • Neuroprotective agents
  • Deep brain stimulation

Guillain-Barré Syndrome

• Syndrome Variants
  • Ascending
  • Pure-motor
  • Descending
  • Miller-Fisher Syndrome
• Treatment Options
  • Plasmapheresis
  • Intravenous immunoglobulin

Amyotrophic Lateral Sclerosis

• Degeneration of Motor Neurons
  • Excitotoxic damage
  • Defect in transport proteins
• Slow and Progressive Weakness
  • Muscle atrophy
  • Paralysis
  • Respiratory failure
  • Death
• Symptom Management
• Alternatives
  • Megadose vitamin
  • Pancreatic enzymes
  • Wheat germ
  • Snake venom
  • Bee pollen

OBJECTIVES

• Explain the appropriate medication management in the care of the multiple sclerosis patient.
• Compare the latest options to manage the various symptoms of the multiple sclerosis patient.
• Illustrate how to provide a therapeutic environment for the Alzheimer’s disease patient.
• Explain the latest drug therapy options available to slow down the progression of Alzheimer’s disease.
• Diagram the pathways to recovery for the patient with myasthenia gravis.
• Analyze treatment considerations for the patient with Parkinson’s disease.
• Contrast the syndrome variants for the patient with Guillain-Barré Syndrome.
• Develop symptomatic management for the patient with amyotrophic lateral sclerosis.