Drugs For Inflammatory Bowel Disease Flashcards

1
Q

Pathogenesis of IBD

A

More pathogenic vs beneficial microbes Is present. Also inappropriate immune responses are present as well.

TH1/TH17 pathways predominant in CD
- TNFa is the most present cytokine

TH2/TH17 pathways predominant in UC
- IL-4 is the most present cytokine

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2
Q

Goals of IBD therapy

A

Induction of clincial remission and maintain remission

Avoid surgery unless needed

Treatment choices = depends on disease severity

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3
Q

What are special formulations of 5-aminosalycilates that can be used for IBD?

A

Depositories

Enemas

PH dependent release capsules

Delayed released capsules

these are used since the bioavailability is 20% off normal oral doses

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4
Q

Azo compounds of 5-ASA

A

Decrease absorption of the drug within the small intestine

However, normal terminal ileum and colon flora have high levels of azoreductase enzymes which cleave the 5-ASA off this drug and activate function
- is more active in colon regions of the bowel

Sulfasalazine = 5-ASA + sulfapyridine

Olsalazine = 2 5-ASA bound together

Balsalazide = 5-ASA bound to 4-aminobenzoyl-B-alanine

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5
Q

What is the purpose of using corticoids with high glucocorticoid potency vs mineralcorticoid potency?

A

Glucocorticoid = actual anti inflammatory actions

Mineralcorticoid = salt/water imbalances

  • *goal is to have high glucocorticoid potency vs mineralcorticoid potency**
  • this is why hydrocortisone can be used for treatment of IBD, but is almost never really used
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6
Q

What enzyme breaks down 6-mercaptopurine into its active form (6-methyl-mercaptopurine)

A

TPMT

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