Aminosalicylates & Azathioprine Flashcards
Key indication for aminosalicylates?
Ulcerative colitis (maintaining remission, treating mild-moderate flare).
Give 3 examples of 5-ASAs
1) mesalazine
2) sulfalazine
3) olsalazine
Give some key side effects specific to sulphalazine (6)
1) Rashes
2) Oligospermia
3) Headache
4) Heinz body anaemia
5) Megaloblastic anaemia
6) Lung fibrosis
What are most of the side effects of sulphalazine due to?
The sulphapyridine moiety
What are some general side effects associated with 5-ASAs? (5)
1) GI upset
2) Headache
3) Agranulocytosis
4) Pancreatitis
5) Interstitial nephritis
Is pancreatitis more common in patients taking mesalazine or sulfasalazine?
7x more common in mesalazine
What is a key investigation in an unwell patient taking aminosalicylates?
Why?
FBC due to risk of agranulocytosis
Which 5-ASA can cause lung fibrosis?
Sulfalazine
Which 5-ASA can cause oligospermia?
Sulfalazine
What are Heinz bodies?
Structures formed from the breakdown of Hb in RBCs.
Key indication for azathioprine?
Crohn’s disease (maintaining remission)
What enzyme is involved in the metabolism of azathioprine (and mercaptopurine)?
Thiopurine methyltransferase (TPMT) enzyme
What test is needed before giving azathioprine?
TMPT test –> to look for deficiency
Deficiency can making individuals prone to azathioprine toxicity.
Who is prone to azathioprine toxicity?
Those with TMPT deficiency
Adverse effects of azathioprine?
1) bone marrow suppression
2) N&V
3) pancreatitis
4) increased risk of non-melanoma skin cancer
