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36 Cards in this Set
- Front
- Back
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what IBD is restricted to colon, loss of haustra, trasnmural inflam, and lead pipe look?
has skipped lesion from mouth to anus, inflam is partial thickness |
UC
CD |
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What are 2 tx goals for IBD
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get into remission
stay in remission |
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what are 5 drug classes used to tx IBD
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5-asa
CS ABX Immunosuppresents monoclonal Abs |
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in IBD, what 2 cytokines play a role?
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PG and LK
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where do PG and LK originate from? what are the assciated enzymes?
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arachidonic acid
PG:COX LK: 5-lipoxygenase |
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What class of agent blocks both COX and 5-lipoxygenase?
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5-ASA
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What do most 5-ASA end in?
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-alazine
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What 2 ways 5-ASA can be given?
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oral and rectal
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do 5-ASA work topically on the GI tract?
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yes
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90% of an oral dose of 5-ASA will be absorbed in the upper GI and metabolized. How do you prevent systemic absorption of these drugs?
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couple it to something that is released in the colon, ER capsule, rectal.
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what 3 5-ASA are coupled to AZO bound?
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sulfasalazine
osalazine balsalazide |
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what is the 1st line drug for Mild to moderate UC or CD to induce remission and maintain remisison?
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sulfasalazine
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what drug for UC or CD may induce male infertility?
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sulfasalazine
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male comes in and has been trying to have children but cannot and you see that he has UC/CD. Drug cause?
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sulfasalazine
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what UC/CD drug can has possible sulfa drug reaction?
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sulfasalazine
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what UC/CD drug is known to cause diarrhea?
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olsalazine
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A 47-year-old male with a history of Crohn’s disease (on no medication currently) presents with an exacerbation of his disease with relatively moderate symptoms. A trial of sulfasalazine is ineffective. He is diagnosed with a perianal fistula. what drug class would you turn to?
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ABX
with mild CD/UC and associated fistula, use ABX. |
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what ABX are used in tx for CD?
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metronidazole
ciproflaxin rifaximin |
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Is the use of ABX in UC effective?
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no, only good for CD.
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Do you use ABX in CD to cause somone to enter remisison, maintain remision, or both?
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to enter remission
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A 35-year-old female is diagnosed with ulcerative colitis. A trial of sulfasalazine is ineffective. She continues to have 3-5 bloody stools per day. What can you do for her? (next drug class)
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CS
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what is the CS used in UC/CD that works topically?
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budesonide
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what receptor does budesonide bind to?
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glucocorticoid receptors
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What is the potential
advantage of budesonide vs. prednisone? |
Budesonide since it is topical has less AE.
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do you use CS in UC/CD to enter someone into remission, maintain remission, or both
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enter remission
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people with CD use are either steroid responsive (can wein off), steroid dependent (cannot wein off), or steroid unresponsive
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blank
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If a person is unresponsive to steroids, or is steroid dependent, or has severe disease and goes into remission with steroids, what else can you do? (next drug)
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immunosuppresents
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what are some immunosupresents used in UC/CD
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azothioprine, MTX, 6-mercaptopurine, cyclosporine
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which immunosuppresent is know for its nephrotox?
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cyclosporin
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what are biological modifiers?
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monoclonal ABs.
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In UC/CD, what do the monoclonal AB target?
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TNF alpha
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What is the difference between infliximab (Remicade) and etanercept (Enbrel)?
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Infliximab is a monoclonal Ab against TNF alpha and etanercept is a recombinat TNF alpha receptor.
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is etanercept effective in the fight against IBD?
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no, only RA
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Many patients with CD need dosage adjustments or lose their response to infliximab. Why might that be?
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infliximab is 25% mouse so some people will start to make ABs against it.
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If someone develops resistance to infliximab, what is the next drug you use?
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adelimumab
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what are the clinical uses of biological modifiers (Monoclonal Abs)
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induce remission in pts unresposive to steroids
wein people off steroids that are steroid dependent maintenance therapy in someone with server IBD |
