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15 Cards in this Set
- Front
- Back
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First-line tx for IBD
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5-aminosalicylates
(thought to act topically) |
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MoA of 5-ASA
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topically, inhibit COX-1, immunosuppressive activity, impair WBC adhesion/cytokine synthesis
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Differences between Pentasa, Asacol, and Azo-compounds.
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location of release of oral 5-ASA
delayed release, pH dependent release, bacterial breakdown |
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impact of 5-ASA
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helps 70% of pts with IBD in remission
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Indication for corticosteroids
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active ulcerative colitis and CD
no role in maintenance |
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key side effect for prednisone in IBD
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osteoporosis
hyperglycemia |
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Benefit of budesonide?
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higher potency, rapid 1st pass metabolism, less systemic effects
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Indications for steroid sparing agents
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>2 courses of steroids in 1 yr
relapse within 6 weeks post-op for complicated CD |
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2 main steroid sparing agents
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azathioprine
-inhibit ribonucleotide synthesis methotrexate -inhibit DHFR |
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Azathioprine efficacy in IBD
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50-70%
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Most common adverse effect in MTX
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N/V
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Anti TNF causes what?
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Blocks TNF, which summons inflammation and dec immune response
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How does lack of response to biologics often occur?
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Body makes antibodies against agents b/c they are proteins
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General UC tx plan
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5-ASA -> Corticosteroids -> immunomodulators -> surgery/cyclosporin/infliximab
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General CD tx plan
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5-ASAs/budesonide/antibiotics -> corticosteroids/immunomodulators -> surgery
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