A client diagnosed with an exacerbation of multiple sclerosis (MS) has been admitted to the medical unit. Included in the admission orders is a prescription for Baclofen 5 mg by mouth, three times daily. What is the expected outcome of this treatment?

Choice A rationale Methotrexate, a disease-modifying antirheumatic drug, primarily works by suppressing the immune system and decreasing inflammation, which slows joint damage and helps control rheumatoid arthritis symptoms. However, it is teratogenic, meaning it can cause severe birth defects, and is also an abortifacient. Therefore, women of childbearing potential must use reliable contraception during treatment and for a specified time after discontinuation (typically one ovulatory cycle or longer) to prevent serious fetal harm. Choice B rationale Baclofen is a centrally acting skeletal muscle relaxant that works by inhibiting monosynaptic and polysynaptic reflexes at the spinal cord level. Its primary effect is to reduce the frequency and severity of skeletal muscle spasms and associated pain, which are common symptoms of multiple sclerosis due to central nervous system damage. Normal therapeutic goals include decreasing spasticity, particularly in the lower extremities, to improve mobility and comfort for the client. Choice C rationale Baclofen is a muscle relaxant, and its effect of reducing spasticity and muscle tone can actually lead to some degree of generalized muscle weakness. It does not act as an anabolic agent or directly improve muscle power. Therefore, increased muscle strength in the upper extremities is not an expected or desired therapeutic outcome of Baclofen treatment in clients with multiple sclerosis. Choice D rationale While Baclofen manages the symptom of spasticity associated with multiple sclerosis, it is not a drug used to modify the disease course or treat the underlying inflammatory process that causes exacerbations. Corticosteroids or plasma exchange are typically used to treat acute exacerbations. Baclofen's role is purely symptomatic relief for muscle spasticity, not prevention or reduction of the severity of disease flares.