Agents for IBD - specific applications Flashcards
ASA
Acetylsalicylic Acid – Aspirin
What do 5-ASA drugs substitute?
Amine at position 5 of ASA
Which drugs in the 5-ASA class are metabolized to Mesalamine (5-ASA)?
Sulfsalazine
Olsalazine
Balsalazide
Sulfapyridine + 5-ASA
Sulfsalazine
Single 5-ASA
Mesalamine
2 molecules of 5-ASA
Olsalazine
Inlet carrier and 5-ASA
Balsalazide
MOA for 5-ASA drugs
(-) cyclooxygenase and (-) lipoxygenase
==> (-) prostaglandin and leukotrienes production
This class of drugs (-) cyclooxygenase and (-) lipoxygenase to ultimately (-) prostaglandin and leukotriene production
5-ASA class
There are fewer side effects with ____ 5-ASA products (NON____)
Fewer side effects with PURE 5-ASA
– NONsulfsalazine
The adverse effects with the 5-ASA group are usually GI and CNS related. When are these drugs contraindicated?
- ALL drugs are contraindicated in patients allergic to ASA
- Sulfsalazine is contraindicated in patients allergic to sulfonamide
5-ASA members are indicated for _____ ulcerative colitis
Mild-Moderate
Olsalazine is only used for?
Maintenance of remission of ulcerative colitis
Balsalazide is only used for?
Active disease of ulcerative colitis
This 5-ASA drug is only used for maintenance of remission of ulcerative colitis?
Olsalazine
This 5-ASA drug is only use for active disease of ulcerative colitis?
Balsalazide
5-ASA members are indicated for ______ ulcerative colitis
Mild-Moderate
MOA for Tofacitinib?
(-) free floating and bound JAK-1 and JAK-3
=> stops pro-inflammatory gene transcription and more cytokine release
MOA for Tofacitinib?
(-) free floating and bound JAK-1 and JAK-3
=> stops pro-inflammatory gene transcription and more cytokine release
Possible adverse effects of Tofacitinib?
- Lymphopenia/Lymphocytosis
- Neutropenia/Anemia
- Increased LDL/HDL
This drug can potentially cause Lymphopenia/Lymphocytosis, Neutropenia/Anemia, and increased LDL/HDL
Tofacitinib
Tofacitinib is NOT recommended for use with other?
Biologic therapies or immunosuppressants
Tofacitinib is NOT recommended for use with other?
Biologic therapies or immunosuppressants
Tofacitinib is indicated for _____ ulcerative colitis
Moderate-Severe
Tofacitinib is indicated for _____ ulcerative colitis
Moderate-Severe
Besides ulcerative colitis, what else can Tofacitinib treat?
Psoriatic and Rheumatoid arthritis
MOA for Ustekinumab
Bind to P40 subunit of IL-12/23 to (-) activation/differentiation of naive T cells and NK cells
MOA for Ustekinumab
Bind to P40 subunit of IL-12/23 to (-) activation/differentiation of naive T cells and NK cells
Adverse effects of Ustekinumab?
INFECTIONs
Adverse effects of Ustekinumab?
INFECTIONs
What is recommended pre-therapy for Ustekinumab?
TB testing
Ustekinumab is indicated for ______ ulcerative colitis and crohn’s disease
Moderate-Severe
Ustekinumab is indicated for ______ ulcerative colitis and crohn’s disase
Moderate-Severe
MOA for TNF-alpha inhibitors?
Binds and neutralizes TNF-alpha
==> blocks pro-inflammatory signaling and leukocyte migration
MOA for TNF-alpha inhibitors?
Binds and neutralizes TNF-alpha
==> blocks pro-inflammatory signaling and leukocyte migration
TNF-alpha inhibitors are given via SQ injection except for?
Infliximab = IV
TNF-alpha inhibitors are given via SQ injection except for?
Infliximab = IV
Adverse effects of TNF-alpha inhibitors?
INFECTIONs
Malignancies
Liver toxicity
Adverse effects of TNF-alpha inhibitors?
INFECTIONs
Malignancies
Liver toxicity
What is recommended pre-therapy for TNF-alpha inhibitors?
TB testing
TNF-alpha inhibitors are indicated for ______ ulcerative colitis/crohn’s disease
Moderate-Severe
TNF-alpha inhibitors are indicated for ______ ulcerative colitis/crohn’s disease
Moderate-Severe
MOA for Alpha-4 integrin inhibitors
(-) integrin associated cell adhesion and migration of leukocytes to inflammation site
MOA for Alpha-4 integrin inhibitors?
(-) integrin associated cell adhesion and migration of leukocytes to inflammation site
Adverse effects of Alpha-4 integrin inhibitors?
Infections
PML with Natalizumab
Adverse effects of Alpha-4 integrin inhibitors?
Infections
PML with Natalizumab
What are 3 risk factors for acquiring PML (progressive multifocal leukoencephalopathy) when using Natalizumab?
- Treatment > 2 years
- Prior immunosuppressant use
- Anti-JC virus antibodies
What are 3 risk factors for acquiring PML (progressive multifcoal leukoencephalopathy) when using Natalizumab?
- Treatment > 2 years
- Prior immunosuppressant use
- Anti-JC virus antibodies
What drug/class can potentially cause PML?
Natalizumab/Alpha-4 integrin inhibitor
What drug classes require TB testing before therapy?
IL-12/23 inhibitors
TNF-alpha inhibitors