IBD Flashcards
name some aminosalicylates (3)
mesalazine
olsalazine
sulfasalazine
what drugs would you use to induce IBD remission and not for long-term therapy?
corticosteroids
what do you need to monitor in someone on steroids?
assess for osteoporosis, assess for cushingoid features, hyperglycaemia, cataracts or glaucoma
name some immunosuppressants used in IBD
azathioprine
methotrexate
biological agents used in IBD
infliximab, adalimumab etc.
does maintenance corticosteroid therapy reduce the risk of relapse in Crohn’s disease?
no
when crohn’s is confined to the distal colon, what treatment might be effective?
topical corticosteriod
+
oral aminosalicylate e.g. mesalazine
what drug isn’t effective if crohn’s has spread outside the colon?
aminosalicylates
how long can a single infusion of infliximab or adalimumab induce remission for in someone with crohn’s disease?
3 months
what option is there for crohn’s disease if it doesn’t respond to medical therapy?
surgical resection
what drugs should be avoided in patienst with UC as they exacerbate symptoms?
NSAIDs and COX-2 inhibitors
what drug, used to treat diarrhoea, can precipitate toxic megacolon if used in UC?
opioids
if UC is limited to distal colon what is best drug to try first?
mesalazine
in form of foam/liquid enemas or suppositories
if repeated coruses of steroids are needed in IBD what drug can be effective?
azathioprine
however - has a slow onset of action (12-16wks)
how would you manage acute severe colitis?
- fluid and electrolyte replacement
- correct anaemia via transfusion
- IV corticosteroid
- infliximab and adalimumab can induce remission in 40% of cases of corticosteroid refractory disease (patients whose symptoms haven’t responded to corticosteroids)
- colectomy if conservative treatmetn cant settle UC
