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19 Cards in this Set
- Front
- Back
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Which inflammatory bowel dz can occur anywhere in the digestive tract, often spreading deep into the layers of affected tissues?
Which usually affects only the innermost lining (mucosa) of your large intestine (colon) and rectum? |
Crohn's dz
UC |
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What is the first pharmacological step in treatment of IBD?
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Anti-inflammatories
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What is the 5-aminosalicyclate used orally to tx mild or moderate UC?
- useful in preventing relapses? - % that respond? - SE? |
Sulfasalazine
- yes - 60-68% - nausea, vomiting, ht burn, HA |
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Mesalamine (and olsalazine)
- mech? - additional effects? - more or less SE than sulfasalazine? - admin? - useful for dz of the sm intestine too? |
- inhibits the cyclooxygenase and 5-lipoxygenase pathways to reduce LTB4 and hydroxyeicosatetraenoic acid (5-production
- may scavenge o2 radicals - less SEs - orally or rectally - no |
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______ enemas can relieve signs and symptoms in more than 80 percent of people with ulcerative colitis in the lower colon and rectum.
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Mesalamine
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What is Balsalazide?
- what % of pts on this med go into remission >12wks? |
another formulation of mesalamine
- 20% |
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Can glucocorticoids be used in IBD tx?
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yes, but only for moderate to severe IBD not responding to other treatments b/c of their SE's.
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Name & class the medication primarily used to tx lower small intestine and proximal large intestine dz.
- more/less SE than traditional corticosteroids? |
Budesonide
- less, and it works faster. |
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Which highly toxic thioguanine deriviatives are used as immunosuppresive agents in the tx of IBD?
- which is used for acute, severe UC? - healing fistulas from Crohn's? (2) - Which inhibits DHFR? |
6-MP, Methotrexate, and Cyclosporine
- cyclo - cyclo - Metho |
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What are Infliximab and Adalimumab?
When are they used, respectively? - respective admin? |
monoclonal antibodies to TNFa.
Inflix: adults/children w/ moderate/severe Crohn's dz who can't tolerate other tx - IV Adalimu: mod/sev Crohn's; only for people who haven't been helped by Infliximab. - subQ |
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Are Infliximab and Adlimumab proven to promote the healing of Crohn's fistulas?
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yes.
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What is CIMZIA?
- mech? - does it induce complement, ab-dependent tox, or Tcell/monoC apoptosis? - admin? |
Certolizumab pegol
- blocks TNFa - no - You initially receive certolizumab pegol as one injection every two weeks. After a few injections, if your doctor determines it's working for you, you receive one injection a month. |
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Can Infliximab & Adalimumab increase the risk of serious infection (TB)? Why?
- most common SEs? - contraindications? |
Yes; TNFa is being bound up --> it's important in innate immunity.
- URI, HA, Rash, Cough, Stomach pain - pts w/ ht failure |
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What is anakinara?
- contraindications? |
a recombinant, nonglycosylated synthetic form of the
human interleukin-1 receptor antagonist (IL-1Ra) mimics the body's endogenous mechanism for regulating IL-1. - Do not take Infliximab or Adalimumab |
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ATG16L1 (gene) is implicated in which dz?
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Crohn’s disease
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1. Decrease in ability to kill bacteria
2. Overactive T cell response to bacteria 3. Inability to tolerate common bacteria 4. Changes in the intestinal cells that make it easier for bacteria to attach Which dz might manifest this way? |
Crohn's dz
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What is Natalizumab?
- mech? - when used re: order of thx? |
mAB against a4-integrin
- Blocks recruitment of immune cells to site of inflammation, thus short circuiting the inflammatory response - tried in those who don't respond to anti-TNF agents. |
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What is the point of giving antiBs to Crohn's pts?
Which drug is now preferred to Metronidazole? |
Antibiotics can heal fistulas and abscesses in people with Crohn's disease. Antibiotics help reduce harmful intestinal bacteria and suppress the intestine's immune system, which can trigger symptoms.
Ciprofloxacin. |
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Are iron supplements, Vit. B12 deficiency, Ca++ and vit D supplements given in Crohn's dz?
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yes.
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