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23 Cards in this Set
- Front
- Back
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Inflammatory bowel disease is comprised of
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Ulcerative colitis or Crohn's disease
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Development of IBD
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Not understood -> genetic predisposition -> cytoplasmic protein in macrophages and gut epithelial cells may be involved in recognition and degradation of bacterial products in the gut wall
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UC characteristics
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Continuous involvement of bowel wall, rectum always involved, colon mucosa usually involved, length of diseased colon varies, inflammation is usually superficial
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CD characteristics
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Transmural inflammation, discontinuous involvement, cobblestone appearance
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Systemic involvement
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Hepatic and biliary abnormalities, arthritis, eye lesions, skin abnormalities
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Corticosteroids are restricted to
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Short term therapy - long term therapy may result in weight gain, hyperglycemia, and cataracts
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Aminosalicylates adverse effects
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Sulfona allergy
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Aminosalicylate agents
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Sulfasalazine, mesalamine, olsalazine, and balsalazide
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Corticosteroid agents
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Prednisone, prednisolone, budesonide, methylprednisolone, hydrocortisone
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Azathioprine and mercaptopurine are useful for
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Maintaining remission and reducing need for long-term corticosteroids
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Methotrexate adverse effects
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Teratogenic effects (category x) and bone marrow depression
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Cyclosporine
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Immunosuppressant indicated for fulminant or refractory symptoms when IV corticosteroids fail
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Nicotine
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Patients with UC show a reduction in symptoms
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What is the only biologic agent routinely used
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Infliximab
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Infliximab dosing
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IV only
5mg/kg at 0, 2 and 6 weeks then every 8 weeks for maintenance |
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BBW for Infliximab
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Risk of serious infection
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Infliximab adverse reactions
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Infusion related reactions (chills) and hepatotoxicity
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Treatment of mild to moderate UC
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Aminosalicylates or mesalamine topically
Corticosteroids 2nd line |
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Treatment of severe or fulminant UC
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IV corticosteroids (hydrocortisone or methylprednisolone)
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Maintenance of remission of UC
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Mesalamine, sulfasalazine, immunosuppressants
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Treatment of mild to moderate CD
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Sulfasalazine or mesalamine or budesonide or prednisone
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Treatment of moderate to severe CD
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Oral corticosteroids
Infliximab is alternative |
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Treatment of severe to fulminant CD
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IV corticosteroids
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