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10 Cards in this Set
- Front
- Back
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Sulfasalazine
type of drug? site of action? use? side effects? |
type: 5- aminosalicylic acid (ASA)
combo of mesalamine (anti-inflammatory) and sulfapyridine (antibacterial) use: crohn's and ulcerative colitis site: cleaved to active form by colon bacteria side effects: sulfa allergy, male infertility (dec swimmer's with sulfasalazine) |
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Mesalamine
routes/types? |
canasa- wax suppository for proctitis
rowasa- enema for left colon (UC) ASACOL- pH sensitive coating for terminal ileum and colon |
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Pentasa
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controlled release 5-ASA (mesalamine) for the small bowel AND colon
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Side effects of steriods
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1. cushingoid features- moon facies, buffalo hump, stretch marks
2. HTN 3. Diabetes 4. osteoporosis 5. infections 6. adrenal suppression |
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Steroid tx
when given? route? how stopped? |
given for flares of IBD, never given for maintenance tx!
route: oral preferred (IV if in hospital) stop: must taper slowly over weeks/mos |
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budesonide
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steroid with extensive first past metabolism so it works in the bowel but does not cause as many side effects (give if worried about steroid SE: infection, DM, HTN etc)
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6-MP, Azathioprine, Methotrexate mechanism?
precautions? |
immune suppression (blocks DNA synthesis so inflammatory cells cannot reproduce)
precaution: do not give 6-MP or Azathioprine with allopurinol (xanthine oxidase inhibitor used for gout)-- get too much immune suppression from shunting down active pathways only |
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methotrexate
indication? SE? |
use for steroid dependent crohn's disease (ONLY CROHN'S)
SE: hypersensitivity pneumonitis-dry cough-discontinue |
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6-mercaptopurine
use? precautions? SE? |
use: to induce and maintain remission of CD and UC
precaution: check TPMT levels first- if low will shunt down other pathway--too much bone marrow suppression if high- abnormal LFTs SE: elevation of LFTs |
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Infliximab
use? mech? route? se? |
use: crohn's and ulcerative colitis with frequent relapses, or steroid dependent or refractory (roids dont work), or steroids contraindicated, crohn's with fistula
mech: antibody (Ab) against TNF-alpha route: IV SE: infections (esp granulomatous so check for TB first, might reactivate- PPD +/- CXR), fever, hypotension, drug induced lupus, PML (progressive multifocal leukoencephalopathy), lymphoma, malignancy, autoimmunity |
