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11 Cards in this Set
- Front
- Back
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Which disease is confined to the colon?
Which disease can effect both small and large bowel? Pathology of the diseases? |
UC
Crohn's immune response to antigen in susceptible individuals |
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Inflammation mediated and amplified by what factors? (3)
Goals of therapy for IBD/Crohn's? (5) |
cytokines (IL1, IL2, TNF-a)
oxygen radicals AA metabolites - leukotriene LTB4 symptom relief, remission, prevention of relapse, fistula healing, avoid surgery |
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Parent compound of the 5-ASA's?
5-ASA's are a conjugate of ________ and _________. What is responsible for most of the AE's? bacterial ____________ in the colon splits the diazo bond and breaks the parent compound. |
sulfasalazine
mesalamine (5-ASA) and sulfapyridine sulfapyridine azoreductase |
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Effects of mesalamine in the body?
Which disease is more responsive to 5-ASA? SE's? |
reduces neutrophil/M(0) chemotaxis, phagocytosis, inhibited cytokine production, IGG
UC fever, malaise, HA, Stevens-Johnson syndrome |
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The _______ prevents early absorption of the aminosalicylate in the upper bowel.
Why is it important to treat pregnant patients with 5-ASA's even though the drugs cross the placenta? |
azo bond
IBD presents more of a threat to the fetus than the drugs' side effects |
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What has been the mainstay of treatment for exacerbations of IBD?
What type of cells do glucocorticoids affect? glucocorticoids ________ AA metabolism, PG and LT production. |
glucocorticoids
lymphocytes inhibit |
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What is the DOC for IBD?
SE's of prednisone? |
prednisone
electrolyte changes - hypo K+, hyper Na+ --> fluid retention --> HTN easier infection growth arrest in children fat redistribution |
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What are the 2nd line drugs for IBD?
MOA? SE's? |
thioguanine derivatives - mercaptopurine, azathioprine
suppress lymphocyte proliferation bone marrow suppression, varying TPMT enzyme activity, opportunistic infections |
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Which drug is given IM to treat Crohn's but NOT UC?
MOA? Which drug is used to treat acute, severe UC unresponsive to glucocorticoids? MOA? |
methotrexate
inhibits dihydrofolate reductase cyclosporin inhibits calcineurin |
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What abx have been shown to have some immunomodulatory activity, and is used for mild-moderate Crohn's?
What drug binds to TNF and neutralizes it? ROA? how many doses? |
Met, Cipro
Infliximab (Remicade) - 1 IV dose usually effective |
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SE's of infliximab?
What should patients be tested for before starting infliximab? |
increased risk of TB, fungal infections, opportunistic infections
latent TB |
