GI Pharm 2

Question 1

Aminosalicylates clinical uses

Answer 1

Induce and maintain remission in UC
Efficacy in Crohn’s is not well established, but often used as 1st line tx of Crohn’s involving the colon or distal ileum.
PO
Enema
Suppository

Question 2

The different Aminosalicylates

Answer 2

Sulfasalazine (Asulfidine) Pregnancy cat. B

Contraindicated in sulfa allergy

Question 3

Aminosalicylates drug of choice

Answer 3

Mesalamine (Asacol, Pentasa) Pregnancy cat. B

Poorly absorbed in the GI tract so works primarily like a topical agent with limited systemic SE and drug interactions

Question 4

Contraindications to Aminosalicylates

Answer 4

Aspirin or other salicylate allergy
Glucose-6-phosphate dehydrogenase deficiency
Sulfasalazine is contraindicated with a history of sulfa allergy

Question 5

Corticosteroids Short term side effects

Answer 5

Increased glucose levels, increased appetite, insominia, anxiety, tremors, increased fluid retention, increased blood pressure

Question 6

Corticosteroids Long term side effects

Answer 6

Decreased bone mineral density, fat redistribution, ulcers from decreased prostaglandin production, hypertriglyceridemia, hirsutism

Question 7

Anti-tumor necrosis factor agentsTNF Inhibitors Side Effects

Answer 7

Black box warning

Reactivation of latent TB

Question 8

TCA’s Contraindications

Answer 8

Narrow angle glaucoma
Recent MI
MAOI’s or Fluoxetine (Prozac) in patients who took them in the previous 2 weeks
Imipramine (Tofranil) Preg. Cat C
Amitriptyline (Elavil) Preg. Cat C
Desipramine (Norpramin) Preg. Cat C

Question 9

Antispasmodics: used to treat IBS

Answer 9

Anticholinergics:
Hyoscyamine (Levbid, Levsin SL)-2nd line
Dicyclomine (Bentyl)-1st line b/c quick onset short T1/2
Belladonna alkaloids:
Donnatol
Clidinium (Librax)