IBD & Cirrhosis Flashcards
2 types of IBD
crohns
ulcerative colities
symptoms of IBD
diarrhea, blood in stool, abdominal pain/cramp, weight loss, fatigue, change in daily activity
2 markers of inflammation in the bowel looked for in stool studies for iBD
lactoferrin and calprotectin
IBD confined to the rectum and colon, often starts in rectum and moves up
ulcerative colitis
depth of ulcerative colitis and nature of disease
mucosa (superficial) and continuous
UC confined to the rectum
proctitis
UC where inflammation goes up past the rectum, sigmoid colon, and descending colon up to the splenic flexure
left sided/distal colitis
UC that passes the splenic flexure
extensive/pancolitis
complications of UC
toxic megacolon, colon cancer, colectomy
IBD located anywhere from mouth to anus
crohns
crohns is most commonly located in the
terminal ileum, but perianal is common too
depth and nature of crohns
deeper but patchy inflammation (cobblestone)
complications of crohns
malnutrition, strictures, fistulas
5-aminosalicylate (5-ASA) used for IBD
mesalamine
primary immunomodulator used for IBD
azathioprine
how long for azathioprine to work for IBD
~6 months
what is often co-administered with AZA for IBD
steroids (allow transition to chronic meds)
biologics- increase biologic efficacy and decrease Ab formation to biologic
BBW for azathioprine
malignancy, especially when used with anti-TNFs
main corticosteroid used for IBD
budesonide
brand for budesonide used for crohns and its target location
entocort –> terminal ileum
brand for budesonide for UC and its target location
uceric –> colon
how long is the budesonide regimen for IBD
8 weeks
which antibiotics are used for IBD
metronidazole
ciprofloxacin (3rd gen ceph alt.)
what risk is associated with all biologics for IBD
infection risk
risk of infusion related reactions
how long must a biologic be given for IBD to determine efficacy
8 weeks
management of an acute biologic infusion reaction
decrease infusion rate, give APAP/benadryl, steroids
management of delayed biologic infusion reaction
APAP, symptomatic management
anti-TNFs used for IBD
adalimumab, infliximab
generic for humira
dose form?
adalimumab, SC
generic for remicade
dose form?
infliximab, IV
BBW for anti-TNF
infection, risk for malignancy (higher with AZA)
which biologics are tried first in IBD
anti-TNF
selective adhesion molecule (integrin) inhibitors used for IBD
natalizumab, vedolizumab
generic for tysabri
dose form?
natalizumab, IV
generic for entyvio
dose form?
vedolizumab, IV
BBW for natalizumab (tysabri)
PML (has REMS)
IL inhibitors used for IBD
usetkinumab, risankizumab, mirikizumab
generic for stelara
dose form?
usetkinumab
IV then SC
generic for skyrizi
dose form?
risankizumab
IV then SC
generic for omvoh
dose form?
mirikizumab
IV then SC
JAK inhibitors used for IBD
tofacitinib, upacitinib
generic for xeljanz
dose form?
tofacitinib
PO