IBD Flashcards
What is the UC pathophysiology?
-appears in rectum and colon, more superficial in nature
-can cause hemorrhoids, anal fissures, perirectal abscesses, toxic megacolon, increased risk for colon cancer
What are the drug related causes for IBD?
NSAIDs (can be causative) and antibiotics (not causative but associated)
What is the CD pathophysiology?
-appears anywhere in GI tract, fistulas are common, nutritional deficiencies are common, hepatobiliary complications, ocular complications, bone and joint complications (arthritis), hematologic and coagulation complications
what are the nonpharmacological therapy recommendations for IBD?
-no specific diet shown to be helpful
-probiotic therapy maybe helpful
-surgery
What are the ASA agents?
sulfasalazine (sulfapyridine + mesalamine)
-mesalamine (need to find right formulation to deliver to correct area)
-Apriso, Lialda, Pentasa, Asacol HD and Delzicol, Olsalazine, Balsalazide
What role do corticosteroids play in IBD?
-induction of remission
-hydrocortisone, budesonide, prednisone, prednisolone
-must supplement calcium and Vitamin D
What role does Azathioprine (AZA) and mercaptopurine (6-MP) have in IBD?
-can be used for maintenance treatment after induction on steroids; for pts who have failed 5-ASA tx
-worry abt life threatening anemias (monitor TPMT)
What role does Cyclosporine have in IBD?
-not recommended for CD only UC
-can be effective in inducing remission
-cannot be used long term
What role does Methotrexate play in IBD?
-used in CD mainly
-may have steroid sparing effects and help induction
What biologics are used for UC only?
golimumab (simponi), mirikizuman (Omvoh), tofacitinib (Xeljanz), Ozanimod (Zeposia), Estrasimod (Velsipity)
What biologics are used for CD only?
certolizumab (Cimza), natalizumab (Tysabri)
What biologics can be used for both CD and UC?
infliximab (remicade), adalimumab (Humira), vendolizumab (Entyvio), ustekinuman (Stelara), risankizumab (Skyrizi), updacitinib (Rinvoq)
What medications have anti TNF activity?
infliximab (Remicade), adalimumab (Humira), golimumab (Simponi), Certrolizumab (Cimzia)
What medications have IL-12 and IL-23 antagonism?
ustekinumab (Stelara)
risankizumab (Skyrizi) - IL-23 antagonist
mirikizumab (Omvoh) - IL-23 antagonist
what medications are JAK inhibitors?
tofacitinib (Xeljanz), upadacitinib (Rinvoq)