Gastroenterology - Pharmacy Teaching (IBD, Nausea, Vomiting) Flashcards
Ulcerative Colitis vs Crohn’s
IBD Scoring: HBI and SCCAI - what are these?
Harvey Bradshaw Index for Crohn’s - not used as much
Simple Clinical Colitis Activity Index for Ulcerative Colitis - used a lot
IBD Scoring: HBI and SCCAI - what are these?
Harvey Bradshaw Index for Crohn’s - not used as much
Simple Clinical Colitis Activity Index for Ulcerative Colitis - used a lot
IBD Scoring - Truelove and Witts
IBD Categorisation
FCPL ranges?
- Flare - Sx = moderate to severe
- FCPL - 0-50 is normal, 50-250 is ok, 300-599 is concerning, >600 worried
Treatment Targets: IBD
Proctitis? - …
Proctosigmoiditis? - Liquid enema and …
Left Sides Colitis? - … enema and … orally
Whole Colon? - Oral medication
Proctitis? - Suppositories
Proctosigmoiditis? - Liquid enema and suppositories
Left Sides Colitis? - Foam enema and medication orally
Whole Colon? - Oral medication
Flare Management pathway - IBD
Flare Management pathway - IBD
UC Maintenance Management: 5ASA
Oral mesalazine (also known as mesalamine) is a 5-aminosalicylic acid compound used in the treatment of mild to moderate … …, with high rates of efficacy in induction and maintenance of remission
Oral mesalazine (also known as mesalamine) is a 5-aminosalicylic acid compound used in the treatment of mild to moderate ulcerative colitis, with high rates of efficacy in induction and maintenance of remission
UC Flare Management
- What do we do?
DOUBLE mesalazine
Does adherence matter in UC?
Yes! helps remission
Steroids; UC and Crohn’s
- … cure - but provide a good effect
- Ensure not …
- … care - often not high enough from GPs
- Concern if >… courses/year
- mirror IBD Sx
- Short cure - but provide a good effect
- Ensure not infective
- Primary care - often not high enough from GPs
- Concern if >2 courses/year
- mirror IBD Sx
Steroids; UC and Crohn’s - Flare up
- Alternative Steroids
- B or B…
Budesonide - PO and Rectal
- 9mg OM 8/52
Beclamethasone - PO
- 5mg OD 4/52 - 5mg Alt days 4/52 then stop
- Non inferior to prednisolone
Define Post Operative Nausea and Vomiting
Postoperative nausea and vomiting (PONV) is defined as any nausea, retching, or vomiting occurring during the first 24–48 h after surgery in inpatients.
Vomiting - pathway
Risk Assessment for N+V
What score is used?
Pharmaceutical Management for N+V
Antihistamines
5HT3 Antagonists
Phenothiazines
Butyrophenones
Anticholinergics
Dopamine Receptor …
Cycylizine - Antihistamine
Ondansetron - 5HT3 Antagonists
Phenothiazine - Prochlorperazine
