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GI 2 Exam 1 > Exam 1 Pharm: Agents for IBD > Flashcards

Exam 1 Pharm: Agents for IBD Flashcards

1
Q

Drug classes used for ulcerative colitis

A 
5-ASA 
JAK inhibitors
IL-12/23 Inhibitors
TNF-a inhibitors
a-4 Integrin inhibitors
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2
Q

Drug classes used for Crohn Disease

A

IL-12/23 Inhibitors
TNF-a inhibitors
a-4 Integrin inhibitors

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3
Q

Nomenclature for 5-ASA agents

A

-sala-

Sulfasalazine
Mesalamine
Olsalazine
Balsalazide

Tx for UC

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4
Q

5-ASA Agents MOA

A

ASA = salisylic acid = COX and LIPOX inhibition (arachadonic acid breakdown pathway)

5-ASA inhibits cyclooxygenase and lipoxygenase, decreasing the production of prostaglandins and leukotrienes (decreased PMN and macrophage chemotaxis)

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5
Q

*5-ASA agents contraindications

A

All 5-ASA contraindicated in ASA allergies

Sulfasalazine contraindicated in sulfa allergies

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6
Q

5-ASA agent indications

-sala- drugs

A

Mild to moderate UC
Active and Maintenance
Mesalamine and Sulfasalazine

[Olsalazine only for maintenance]
[Balsalazide only for active]

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7
Q

TNF-a Inhibitors for UC

A

*Adalimumab
Golimumab (starts with G for “g”olitis)
*Infliximab

*=both UC and CD

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8
Q

TNF-a Inhibitors for CD

A

*Adalimumab
Certolizumab (starts with C for CD)
*Infliximab

*=both UC and CD

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9
Q

TNF-a Inhibitors MOA

A

monoclonal abs bind TNF-a, blocking leukocyte migration to site of inflammation

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10
Q

Administration routes for TNF-a inhibitors

A

All subcutaneous injection (adalimumab, golimumab, certolizumab)

Except Inflixumab is given IV (starts with I for IV)

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11
Q

*Which drug classes for UC/CD treatment need TB testing pre-therapy?

A

TNF-a inhibitors

IL-12/23 inhibitors (Ustekinumab)

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12
Q

Adalimumab drug class and indication

A

UC and CD

TNF-a inhibitor

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13
Q

Infliximab class and indication

A

CD and UC

TNF-a inhibitor

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14
Q

Golimumab class and indication

A

UC

TNF-a inhibitor

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15
Q

Certolizumab class and indication

A

CD

TNF-a inhibitor

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16
Q

*When should TNF-a inhibitors be used?

A

After conventional immunosuppressant therapy has failed (moderate to severe UC or CD)

17
Q

a-4 Integrin inhibitor for UC

A

Vedolizumab (used for both UC and CD)

18
Q

a-4 Integrin inhibitors used for CD

A

Vedolizumab (used for both UC and CD)

Natalizumab (CD only)

19
Q

a-4 Integrin inhibitor MOA

A

binds integrin-associated cell adhesion molecules (i.e. VCAM), limiting trans-endothelial migration of leukocytes

20
Q

*Critical potential side effect of natalizumab (a-4 integrin inhibitor)

A

Progressive multifocal leukoencaphalopathy associated with JCV (john cunningham virus)

21
Q

*When should a-4 integrin inhibitors be used?

A

After conventional immunosuppressant therapy has failed (moderate to severe UC or CD)

22
Q

IL-12/23 inhibitor used for UC and CD

A

Ustekinumab

23
Q

IL-12/23 inhibitor MOA

A

Binds P40 subunit of I-12 and IL-23, blocking activation of T-cells and NK cells

24
Q

IL-12/23 inhibitor indication

A

After conventional immunosuppressant therapy has failed (moderate to severe UC or CD)

25
Q

______ is a 5-ASA agent that can ONLY be used for maintenance of UC

A

Olsalazine

only for maintenance of UC

26
Q

______ is a 5-ASA agent that can ONLY be used for active of UC

A

Balsalazide

only for active UC

27
Q

JAK inhibitor MOA

A

blocks JAKs, preventing transmission of signals arising from pro-inflammatory cytokines, therefore preventing pro-inflammatory gene transcription and expression

28
Q

Tofacitinib drug class

A

JAK inhibitor

T in Tofacitinib for Tyrosine kinase (JAK)

29
Q

JAK inhibitor (tofacitinib) indication

A

Moderate to severe UC

Active and maintenance

30
Q

*JAK inhibitor (tofacitinib) contraindication

A

Do not use tofacitinib with other monoclonal abs or immunosuppressants

31
Q

Glucocorticosteroid indication in UC and CD

A

Acute and/or severe UC or CD uncontrolled by other conventional methods

*not for maintenance unless absolutely necessary

32
Q

Drug class of choice for mild-moderate UC

A

5-ASA

-sala-

GI 2 Exam 1 (7 decks)

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