Adult IBD meds

Question 1

Aminosalicylates for IBD

Answer 1

Example: Sulfasalazine

MOA: In the colon produces local anti-inflammatory
effects; reduces symptoms.

Dosage: Initial 500 mg every 6—12 hr; up to 1 g every 6-12 hr
Maintenance: 500 mg every 6 hr

Used for UC. Assess for sulfonamide and salicylate allergy. Monitor for blood dyscrasias (CBC with differential and liver function tests).

Question 2

Glucocorticoids for IBD

Answer 2

Example: Prednisolone

MOA: Inhibit the inflammatory response by decreasing leukotriene and prostaglandin production.

Dosage: 5-60 mg/day

Caution: may suppress signs/symptoms of infection.

Question 3

Immunomodulators for IBD

Answer 3

Example: Azathioprine

MOA: Suppresses immunity and antibody formation by inhibiting synthesis of DNA and RNA.

Dosage: 50 mg daily, may increase by 25 mg/day over 1-2 weeks with a max dose of 2—3 mg/kg/day.

Used in CD and UC. Caution: teratogenic properties; avoid exposure to live viruses or infectious
diseases.

Question 4

Biological response modulators for IBD

Answer 4

Example: Infliximab
Adalimumab

MOA: Anti- inflammatory response by inhibiting tumor necrosis factor- alpha (TNF- alpha), used to help heal fistulas of CD.

Dosage: IV: initial dose 5 mg/kg; repeat at 2 and 6 weeks; maintenance 5 mg/kg every 8 weeks.

Used for CD when other drugs fail to control symptoms. Monitor for signs/symptoms of infection.

Question 5

Antibiotics for IBD

Answer 5

Example: Metronidazole

MOA: Inhibits protein synthesis; used with anaerobic bacterial caused infections.

Dosage: 250-500 mg tid to qid for 10-14 days.

Treatment of diarrhea caused by C. difficile.
Caution: increases risk of Stevens-Johnson syndrome.