Drugs-IBD Flashcards
Th1 and Th17 important in?
CD
Th2 and NK cells important in?
UC
this drug is used to maintain remission in UC, also reduces risk of colon cancer by 75%
5-ASA
at high doses, this drug can induce remission in mild UC/CD
5-ASA
this drug acts topically
5-ASA
5-ASA also called?
mesalamine
pentasa works by releasing mesalamine in?
microgranules; causes delayed release in small intestine and colon as water diffuses and pushes granules out
asacol acts of the ileum and colon by?
combining mesalamine with eudragit-S, making it pH dependent
Azo-combounds act only on the colon because?
they the diazo bond is broken down by bacteria in the colon
this drug has very few side effects and puts 70% of people into remission
5-ASA
this is used to INDUCE but not to maintain remission in moderate to severe ACTIVE IBD
corticosteroids
this is supplied orally and rectally
corticosteroids
numerous side effects limit the longterm use of this otherwise very effective drug
corticosteroids
side effects of corticosteroids
osteoporosis, compression fractures, weight gain, cataracts, abdominal fat, moon facies, bruising and poor wound healing
advantage of budesonide over other steroids
rapid first pass metabolism and ileal release = less systemic effects
who gets budesonide?
mild to moderate ileal crohn’s dz
what is still at risk using budesonide?
bones
these drugs can be used for active dz and/or remission maintenance for both UC and CD, but are generally preserved for those with severe cases and/or consistent need for steroids
immunomodulators (azathioprine, methotrexate)
azathioprine inhibits ______ and induces?
ribonucleotide synthesis; T cell apoptosis
methotrexate inhibits ____ and should be co-administered with ____ to reduce myelosuppression and mucositis
DHFR; folate
30% of pts on azathioprine fail due to intolerance or no response – what are the side effects/risks?
myelosuppression, pancreatitis, hepatotoxicity, nausea, myalgias; RISK of lymphoma, HPV, infection
serious AE of methotrexate
hepatic and pulmonary toxicity, myelosuppression, birth defects (monitor LFTs, CBC)
anti-TNF antibodies are administered _____ because?
shots/IV; stomach acid would denature protein
give anti-TNF to?
active, severe Crohn’s pts (either top down or step up tx)
anti-TNF works by?
blocking WBC recruitment
side effects of monoclonal ab tx (anti-TNF)
decreased response over time; serum sickness
surgery is a good option for?
UC
5-ASAs are less effective for (UC/CD)
CD
antibiotics can be used as a first line tx for (UC/CD)
CD
in Crohn’s dz, these two therapies are given together
corticosteroids & immunomodulators
new therapies for IBD are directed against?
leukocyte trafficking (alpha-4 integrins)
