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P3 Therapeutics > IBD > Flashcards

IBD Flashcards

1
Q

infliximab indications

A

UC and CD
may be preferred for UC induction or fulminant UC

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2
Q

adalimumab indications

A

UC and CD induction and mx
can use in pts with poor response to infliximab

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3
Q

TNF inhibitors ADRs

A
  1. increased risk of infection
  2. injection site rxns
  3. risk of malignancy
  4. risk of demyelinating disease
  5. CHF exacerbation
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4
Q

golimumab indications

A

UC ONLY - induction and mx

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5
Q

certolizumab indications

A

CD ONLY - induction and mx

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6
Q

ozanimod and estrasimod indications

A

UC ONLY - moderate-severe

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7
Q

varicella vaccine is recommended prior to starting which treatments?

A

ozanimod and estrasmiod

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8
Q

which drugs are metabolized by CYP3A and therefore need to be monitored with CYP3A inducers/inhibitors ?

A

tofacitinib
upadacitinib

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9
Q

In which patients would you consider use of Xeljanz or Rinvoq?

A

in patients who had an inadequate response or are intolerant to TNF blockers

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10
Q

Ozanimod is contraindicated with what?

A

MAOIs

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11
Q

vedolizumab and ustekinumab indications

A

UC and CD - induction and mx

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12
Q

CDAI 150-220

A

mild-moderate CD, ambulatory with minimal symptoms

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13
Q

CDAI 220-450

A

moderate-severe CD, patient who fail therapy for mild-moderate or with major symptoms

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14
Q

CDAI > 450

A

severe-fulminant CD, persistent symptoms despite steroid or biologic use, presence of cachexia, obstruction, or abscess

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15
Q

Fistulas are common in: CD or UC?

A

CD

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16
Q

The inflammation is deeper in: CD or UC?

A

CD

17
Q

What is the most common affected site in CD?

A

terminal ileum

18
Q

What is the active and inactive component of sulfasalazine?

A

inactive = sulfapyridine (associated with ADRs)
active = 5-ASA (mesalamine)

19
Q

What dosage forms is mesalamine typically in? Which dosage form is usually most effective?

A

-topical (enema)
-suppository
-oral DR/CR tablet

topical is generally more effective than oral

20
Q

ASA agents - ADRs

A

N/V, headache, anorexia, rash

21
Q

How to avoid ADRs with ASA agents

A

initiate at low dose and increase slowly over 1-2 weeks

22
Q

ASA agents drug interactions

A

-antiplatelets/anticoagulants
-NSAIDs
-> may increase bleeding risk
-agents affecting gastric pH (PPIs, H2RAs, antacids) - could affect release of drug

23
Q

Which ASA agent has the highest incidence of diarrhea?

A

Olsalazine

24
Q

Which routes are corticosteroids used for IBD?

A

oral, rectal, parenteral
*rectal hydrocortisone common

25
Q

What supplements should be given while on steroids?

A

calcium and vitamin D

26
Q

Azathioprine and 6-MP indications

A

-long-term tx of UC and CD - maintenance
-maintain remission, steroid-sparing
-reserved for pts who fail 5-ASA tx or pts dependent on steroids

27
Q

Azathioprine and 6-MP ADRs

A

N/V/D, anorexia
bone marrow suppression
hepatotoxicity
fever, rash

28
Q

Methotrexate indications

A

CD - assist in inducing remission, steroid-sparing effects

29
Q

Methotrexate ADRs

A

bone marrow suppression, mucositis, cirrhosis, pneumonitis, rash, alopecia, teratogenic

30
Q

TNF-a antagonists

A
  1. infliximab
  2. adalimumab
  3. golimumab
  4. certolizumab
31
Q

Infliximab has an increased risk of which malignancy?

A

hepatosplenic T-cell lymphoma

32
Q

Which biologics require an infusion?

A

-infliximab
-natalizumab
-vedolizumab

33
Q

Corticosteroids short-term adverse effects

A
  1. hyperglycemia
  2. gastritis
  3. mood changes
  4. elevated BP
34
Q

Corticosteroids long-term adverse effects

A
  1. aseptic necrosis
  2. cataracts
  3. obesity
  4. growth failure
  5. osteoporosis
35
Q

Methotrexate contraindications

A
  1. pregnancy
  2. immunodeficiency
  3. blood dyscrasias
  4. chronic liver disease
  5. pleural effusions
  6. leukopenia/thrombocytopenia
  7. CrCl < 40
36
Q

ozanimod and estrasimod ADRs

A
  1. increased risk of infection
  2. bradycardia/AV conduction delays
  3. potential risk of PML
  4. increased BP
  5. increased LFTs/liver injury
  6. macular edema
  7. respiratory effects
  8. reversible posterior leukoencephalopathy syndrome
37
Q

T/F: 5-ASA therapy may be used for severe UC

A

FALSE - used for moderate disease

P3 Therapeutics (15 decks)

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