Agents for Inflammatory Bowel Disease Flashcards
What type of medications are used to treat IBD?
- Corticosteroids
- Aminosalicyclates
- Immunosuppressives
- Monoclonal Antibodies
Sulfasalazine is cleaved by bacteria in the colon to produce what 2 compounds?
- Sulfapyridine (Sulfonamide Antibiotic)
- Mesalamine (5-aminosalicyclic acid, 5-ASA)
What is the active component of sulfasalazine for IBD?
Mesalamine or 5-ASA is the metabolite active vs IBD.
Formulation into sulfasalazine is necessary to prevent rapid proximal gut absorption so that sufficient 5-ASA is delivered to the distal gut to effectively treat IBD
How does Mesalamine work in the treament of IBD?
- Anti-inflammatory effects
- Immunomodulating effects
What type of vitamin supplementation should pts receive while on sulfasalazine?
Folic acid
Sulfasalazine may interfere with absorption of folic acid in the gut–> Megaloblastic anemia
What type of immunosuppressives are used to treat IBD?
- Cyclosporine A
- Methotrexate
- Azathioprine
- 6-Mercaptopurine
What is the monoclonal antibody indicated for the treatment of Crohn’s disease, Ulcerative Colitis & Rheumatoid Arthritis?
Infliximab
Infliximab MOA?
Monoclonal antibody that binds to soluble & bound forms of TNF-alpha (classic pro-inflammatory cytokine)
Once remission has been achieved w. UC, what medications are used as maintenance therapy?
Aminosalicylates or Immunosuppressive agents are used for maintenance therapy for UC.
Corticosteroids should not be used to maintain disease remission due to their high systemic toxicity.
What are the toxicities associated w Infliximab?
- Respiratory Infection (including reactivation of TB)
- MUST have PPD checked prior to starting
- Fever
- Hypotension
What are the toxicities associated with Sulfasalazine?
- Malaise
- Nausea
- Sulfonamide toxicity
- Reversible Oligospermia
