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GIGU 2 Exam 1 > Agents For IBD - Dr. Segars > Flashcards

Agents For IBD - Dr. Segars Flashcards

1
Q

5 classes of drugs for UC

A
  1. 5-ASA
  2. Janus Kinase
  3. IL-12/23 Inhibitors
  4. TNF-a inhibitors
  5. a-4 Integrin Inhibitors
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2
Q

3 classes of drugs for CD

A
  1. IL-12/23 Inhibitors
  2. TNF-a inhibitors
  3. a-4 Integrin Inhibitors
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3
Q

4 5-ASA agents

A
  1. Sulfasalazine
  2. Mesalamine (the main active compound 5-ASA that the others break down to)
  3. Olsalazine
  4. Balsalazide
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4
Q

1 Janus Kinase (JAK) inhibitor

A

Tofacitinib

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5
Q

1 IL-12/23 Inhibitors

A

Ustekinumab

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6
Q

4 TNF-a inhibitors

A
  1. Adalimumab
  2. Infliximab
  3. Golimumab (UC)
  4. Certolizumab (CD)
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7
Q

2 a-4 Integrin Inhibitors

A
  1. Vedolizumab

2. Natalizumab (CD)

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8
Q

5- ASA is what

A

AcetylSalicylic Acid (ASPRIN) product

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9
Q 
Components of 
Sulfasalazine 
Mesalamine
Olsalazine
Balsalazide
A

Sulfasalazine : sulfapyridine + 5-ASA
Mesalamine : 5-ASA
Olsalazine : 2 5-ASAs
Balsalazide : inert carrier + 5-ASA

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10
Q

Side effects from 5-ASA is what

A

Sulfapyridine (sulfasalazine is not the one we give anymore)

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11
Q

5-ASA MOA

A
  1. Inhibits COX and LIPOX pathways = ——I progesterone and leukotriene
  2. M decrease
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12
Q

5-ASA side effects

A
  1. Anaphylaxis from aspirin allergy (NEVER GIVE)

2. Sulfasalazine dont give to sulfonamide allergic pts, + overall has more side effects

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13
Q

5-ASA is sued for what

A

Maintenance and ACUTE*
= mild to moderate ulcers
= Olsalazine only maintenance
= Balsalazide only acute active UC

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14
Q

TNF-a inhibitors

MOA

A

TNF-a = Cytokine that increases surface adhesion (VCAM, E-selectin, for N and leukocyte adhesion)
1. This drug inhibits leukocyte migration and adhesion

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15
Q

Drug ending in -mab means what

A

It is a monoclonal Ab (usually IgG)

All are injectable (SQ, except infliximab is by IV)

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16
Q

TNF-a inhibitors side effects

A

High infection risk

  • latent TB and come back (so do TB test first)
  • BACK BOX : sepsis, high infection risk (esp with steroid drugs), monitor closely
17
Q

TNF-a inhibitors

Used for what

A
  1. Adalimumab : moderate to severe (due to side effects), UC + CD
  2. Infliximab : moderate to severe CD, Severe UC
  3. Golimumab : moderate to severe UC
  4. Certolizumab : moderate to severe CD
18
Q

a-4 Integrin inhibitors MOA

A

a-4 Integrins : receptor on leukotriens and N to bind to VCAMs and binding sites for adhesion and migration
= this drug blocks this

19
Q

a-4 Integrin inhibitors is given how

A

By IV injection

Also IgG monoclonal AB

20
Q

a-4 Integrin inhibitors side effects

Major one

A

BLACK BOX : Risk of infections (especially PML = John Cunningham Virus** when taking Natalizumab)

  • treatment over 2ys
  • prior immunosuppression tx
  • have anti-JC virus ABs
21
Q

a-4 Integrin inhibitors side effects

Minor ones

A
  1. Infusion related problems
  2. Increase malignancy risk (Vedolizumab)
  3. Can make anti-medication ABs
22
Q

a-4 Integrin inhibitors used when

A
  1. Natalizumab : moderate to severe CD, dont use with another immunosuppressant
  2. Vedolizumab : moderate to severe UC + CD
23
Q

a-4 Integrin inhibitors should be given when

A

After pt does not respond to other drugs or TNF-a inhibitors therapy

24
Q

IL12/23 inhibitors MOA

A

Inhibits these pro inflammatory cytokines

= drug binds to P40 of IL12/IL23 which blocks T-cell + NK-cell activation

25
Q

IL12/23 is given how

A

IV or SubQ injections (also IgG monoclonal AB)

26
Q

IL12/23 inhibitors side effects

A

Infections (monitor health)

  • get TB test before giving drug
  • injection related allergic reactions
  • rare increase in malignancy
27
Q

IL12/23 inhibitors is used for what

A

Ustemumab : Moderate to severe UC + CD

28
Q

IL12/23 inhibitors when would you give this to a patient

A

Then intolerant or not working with other conventional drugs, steroids, or TNF-a therapy

29
Q

JAK inhibitors MOA

A

When phosphorylated they transcribe more pro inflammatory genes
= the drug inhibit free floating JAK1 + JAK3 so they can’t dimerize and be phosphorylated

30
Q

IL12/23 inhibitors side effects

A

BLACK BOX : increased risk of cardiac events, MI, clots, death

  1. Lymphopenia/ Lymphocytosis
  2. Neutropenia, anemia
  3. Increase LDL, HDL
  4. Rare risk in malignancy + infection
31
Q

IL12/23 inhibitors is used for what

A

Tofacitinib : moderate to severe UC
(Also psoriasis, and RA)
* dont use with other therapies or immunosuppressants

32
Q

Glucocorticosteroids used when

A
  1. N/V
  2. Acute and severe UC + CD (for most fast acting drug), usually not for maintenance (for needed fast reduction in pro inflammation)

GIGU 2 Exam 1 (12 decks)

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