16 - Management of IBD

Question 1

least intense class of drugs used to treat IBD

Answer 1

salicylates

Question 2

mesalamine, sulfasalazine

Answer 2

salicylates used to treat IBD - basically deliver ASA to bowel

Question 3

sulfasalazine SEs

Answer 3

rash, fever, HA, nausea, dyspepsia, neutropenia, hepatitis, male infertility, hemolytic anemia, agranulocytosis, alveolitis, pancreatitis

Question 4

budesonide

Answer 4

corticosteroid that has very high first pass effect so it has little systemic effect. used to treat IBD

Question 5

3 immunosuppressives used to treat IBD

Answer 5

6 mercapto purine and azathioprine and methotrexate

Question 6

SEs of 6MP and AZA

Answer 6

allergic rxn type sx
GI disturbances
hepatotoxicity
infxn
pancreatitis
bone marrow suppression
malignancy/lymphoma

Question 7

AZA metabolsim

Answer 7

a significant number of people lack TPMT > dec metabolism rate of AZA > inc bone marrow suppression

Question 8

what drug cannot be given with 6MP / AZA?

Answer 8

allopurinol

Question 9

natalizumab is anti-…

Answer 9

integrin

Question 10

infliximab and adalimumab are anti-…

Answer 10

TNF

Question 11

big problem w/ natalizumab

Answer 11

PML from JC virus

Question 12

when do you generally resort to surgery for Crohn’s?

Answer 12

obstructions, abscess, medical failure

higher tendency of recurrence than UC b/c affects small intestine too

Question 13

specific kind of lymphoma pts undergoing tx for IBD are at risk for, and what demographic subset is more at risk?

Answer 13

hepatosplenic T cell lymphoma

young males