IBD Flashcards
IBD Drugs associated with increased risk of lymphoma? Especially highest in?
Thiopurines (6-MP and AZA)
Patients over 50
IBD drugs to avoid during pregnancy?
Methotrexate, ciprofloxacin, metronidazole
Live attenuated vaccines that should be avoided in IBD?
MMR
VZV
Yellow fever
therapeutic 6-TGN level?
230+ pmol/8x108 RBC
In UC, when should colectomy be considered (for dysplasia)?
if invisible dysplasia is confirmed after controlling the inflammation
Treatment for calcium oxalate stones?
High calcium, low oxalate, low fat diet
Can add cholestyramine
Treatment of uric acid stones?
hydration and alkalization of the urine using potassium bicarbonate or potassium citrate.
Lab monitoring after starting tofacitinib?
lipid panel assessment is recommended within four to eight weeks of initiation of therapy
Avoid anti-TNF drugs in these patients:
TNF - tumors/TB, neuritis, heart Failure
- optic neuritis/multiple sclerosis
- Latent TB with under 4 weeks of treatment
- solid tumor treated under 5 years ago
- heart failure
Mechanism:
Vedolizumab?
ustekinumab?
anti-integrin
IL12/IL23 inhibitor
thin, concentric, diaphragm-like septa with a pinhole-sized lumen and considered pathognomonic for?
NSAID-induced enteropathy
Adequate infliximab level?
> 5 mcg/ml
distribution of anti-TNF-induced psoriasis?
Treatment?
If treatment fails?
Palms, soles, and scalp distribution
topical therapies (corticosteroid, keratolytics, emollients, or ultraviolet lights)
Switch to Ustekinumab
Mechanism of cyclosporine?
Salvage therapy for?
risk of neurotoxicity and seizures was found to be highest for patients with
calcineurin inhibitor -> suppresses inflammation by inhibiting the production of IL2
acute severe ulcerative colitis refractory to IV steroids
low serum cholesterol (less than 100mg/ dl)
TPMT?
TPMT mutations - level will be? implication?
Breaks down thiopurines
decreased-to-absent enzyme activity
Higher risk of leukopenia when treated with azathioprine and 6-MP
