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Clin Therapeutics 1 > Exam 4 - IBD meds > Flashcards

Exam 4 - IBD meds Flashcards

1
Q

Where does Pentasa work?

A

Entire GI tract, from Duodenum to Rectum.

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2
Q

What class is Pentasa?

A

Aminosalicylates 5-ASA Mesalamine

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3
Q

What route is Pentasa? What not to do?

A

PO. Do not crush!

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4
Q

CI for Pentasa?

A

Salicylate allergy

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5
Q

Where does Budesonide work?

A

Right/ascending colon and ileum.

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6
Q

What is DOC for IBD of ascending/right colon or ileum?

A

Budesonide

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7
Q

Can Budenoside help induce remission in UC?

A

Yes

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8
Q

Where do all the “-salazines” work?

A

Colon and rectum. LI only.

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9
Q

Which is only IBD drug to work in the Jenunum and Duodenum?

A

Pentasa

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10
Q

Canasa is a suppository which only works where?

A

Rectum

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11
Q

Enemas work in which two locations?

A

Rectum and sigmoid colon

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12
Q

What happens to Sulfasalazine in the gut?

A

Bacteria cleave and becomes active Mesalamine

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13
Q

ADRs of Sulfasalazine?

A
  • Skin/urine organge-yellow
  • Folic acid malabsorption
  • Hemolytic anemia in G6PD decifiency
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14
Q

CIs of Sulfasalazine?

A

Sulfa and Salicylate drugs.

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15
Q

MOA for AZA?

A

AZA -> 6-MP

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16
Q

What does AZA inhibit?

A

T-lymphocytes

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17
Q

What does 6-MP inhibit?

A

DNA synthesis

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18
Q

How long does AZA/6-MP take to work?

A

3 months to 1 year.

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19
Q

AZA/6-MP for induction or maintenance of remission?

A

Maintenance only! Takes 3 months to 1 year to work!

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20
Q

AZA and bone marrow suppression- how?

A

TMPT gene produces enzyme to convert AZA to 6-MP. Lack of enzyme causes increased AZA resulting in leukopenia.

21
Q

Can AZA cause lymphoma?

A

Yes. Skin cancer from long-term use of AZA.

22
Q

AZA causes which organ to become toxic?

A

Hepatotoxicity

23
Q

MOA of MTX (immunomodulator)? (hint: 2)

A

Inhibit dihydrofolate reductase and DNA synthesis

24
Q

MTX in CD or UC

A

CD only!!

25
Q

MTX dosed how often? Route?

A

IM q week

26
Q

What else to give with MTX?

A

Folic acid

27
Q

3 ADRs of MTX?

A

Myelosuppression, hepatotoxic, nausea

28
Q

MOA of Cyclosporine (immunomodulator)?

A

Calcineurin-inhibitor

29
Q

Cyclosporine reserved for when in IBD?

A

Severe, refractory cases

30
Q

Cyclosporine IV vs PO does what?

A

IV=induce remission

PO=w/AZA for maintenance

31
Q

ADR of Cyclosporine?

A

Nephrotoxic

32
Q

TNF inhibitors used for which IBD more than the other?

A

CD&raquo_space; UC

33
Q

TNF inhibitors end in what”

A

“-mab”

34
Q

What stage of IBD to use TNF inhibitors?

A

Moderate to Severe is conventional therapy fails

35
Q

Which TNF-inhib is IV only? Other route?

A

Remicade IV only. Rest are SC.

36
Q

Simpuni is for which moderate-to-severe IBD?

A

UC

37
Q

What can TNF inhibitors reactivate?

A

Latent TB and Hep B.

38
Q

TNF Inhib caution with which condition?

A

III/IV HF

39
Q

TNF Inhib can develop antibodies which which med?

A

AZA

40
Q

What sort of reactions with TNF Inhib?

A

Hypersensitivity

41
Q

What are the two classes of “biologics”?

A
  1. TNF-inhibitors

2. Anti-Alpha 4 Integrin

42
Q

Entyvio (vedolizumab) MOA? Route?

A

Anti-alpha 4 integrin. IV.

43
Q

Entyvio (vedolizumab) use?

A

Moderate to severe UC/CD if conventional therapy fails.

44
Q

Entyvio (vedolizumab) and JC virus?

A

If positive for JC virus only use 9-12 months before using Tysabri.

45
Q

PML and Entyvio (vedolizumab)?

A

Rare

46
Q

Tysabri (natalizumab) MOA? Route?

A

Anti-alpha 4 Integrin. IV.

47
Q

Tysabri (natalizumab) use?

A

Moderate to severe CD (only!) in PT w/o response to conventional tx or other anti-TNF.

48
Q

PML and Tysabri (natalizumab)?

A

Big problem. Enroll in TOUCH program. Risk increases with # of infusions.

Clin Therapeutics 1 (12 decks)

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