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21 Cards in this Set
- Front
- Back
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What are the 4 things included in inflammatory bowel disease?
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Ulcerative Colitis
Crohn's disease Indeterminant colitis Lymphocytic colitis |
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What is the effect of ethnicity on inflammatory bowel disease?
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Higher in whites, jews
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What is the affect of smoking on inflammatory bowel disease?
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Fewer people smoking have UC, more people smoking have CD
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What anti-diarrheal/anti-spasmodic agents are used in inflammatory bowel disease? What are their affects and problems?
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Opiates - slow motility, avoid in severe colitis
Muscarinic anticholinergies - to relieve cramping, anticholinergic side effects Resins - absorb bile salts, vitamin malabsorption |
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How are antibiotics used in inflammatory bowel disease?
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Bacterial overgrowth
Parasites (metronidazole) C. diff (metronidazole or vancomycin) Fistulous & perianal Dx (metronidazole, quinolone |
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Metronidazole (Flagyl): AEs
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Nausea
Neuropathy Disulfuram-like reaction Teratogen? |
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Sulfasalazine: what happens upon administration?
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Congener of 5-ASA and sulfapyridine. Azo bond is cleaved by colonic bacteria, and 5-ASA is therapeutic.
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SAZ: absorption?
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5-ASA remains in the colon and is topically active there. SP is rapidly absorbed and acetylated in the liver
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SAZ: AEs?
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Allergic
Toxic side effects Sperm motility disorders |
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Why can't you give straight 5-ASA?
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Given orally is rapidly absorbed and never reaches ileum or colon. Is toxic to the kidneys.
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What are the 2 types of preparations of 5-ASA with 2 examples each?
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SAZ, Olsalazine (azo-linked compounds)
Pentasa and Asacol (coated form |
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What is SAZ used for?
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Mild to moderately active UC
Maintenance of remission of UC |
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5-ASA: uses compared to SAZ?
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As effective with equivalent doses but less side effects.
Can be used in Crohn's disease |
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Olsalazine: AEs
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Can cause watery diarrhea
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5-ASA: AEs
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Rare allergic reactions, even with rectal administration
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How are corticosteroids used in IBD?
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Anti-inflammatory: remittive, but not effective in maintaining remission
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AZA: what happens once administered? AEs?
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Metabolized to 6-MP
Delayed therapeutic effect Leukopenia, thrombocytopenia Drug interaction with allopurinol Increased risk of CA |
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Cyclosporine, tacrolimus: use now?
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Not used, because side effects preclude long-term use
Replaced by Anti-Tumor Necrosis Factor antibodies |
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What is the name of the anti-TNF antibody?
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Infliximab
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What are anti-TNF antibodies used for?
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Severe Crohn's colitis
Fistulas UC |
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What is the purpose of rectal agents for IBD?
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Avoid systemic side effects by drug targeting
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