IBD drugs Flashcards
what are the 5-ASA drugs and suffix to look for? and what disease are they used for
Sulfasalazine*
Mesalamine
Olsalazine*
Balsalazide*
“sala”
Ulcerative Colitis
What is the Janus Kinase Inhibitor and what disease is it used for
Tofacitinib
Ulcerative Colitis
What are the 3 TNF-a Inhibitors and what disease is it used for
Adalimumab
Golimumab
Infliximab
Ulcerative Colitis
What is the one a-4 Integrin inhibitors and what disease are they used for
Vedolizumab
used for Ulcerative Colitis
What are first line therapy drugs that are not covered in this lecture that are used for both Ulcerative Colitis and Crohns disease
Steroids, Immune Modulators, and even antibiotics also utilized as first-line therapy but not officially indicated, and covered elsewhere in the Curriculum
What are the IL-12/23 inhibitors and what disease are they used for
Ustekinumab
what TNF-a Inhibitors are used for Crohns disease
Adalimumab
Certolizumab
Infliximab
what are the 2 a-4 integrin inhibitors used in Crohns disease
Natalizumab
Vedolizumab
What are the 5-ASA agents mechanism of action
Inhibition of Prostoglandin and Leukotriene production via the arachidonic acid pathway
inhibits both Cyclooxygenase and Lipoxygenase
Reduction in PMN & macrophage chemotaxis
May also inhibit the activation of NFκB(nuclear factor kappa-light-chain-enhancer of activated B cells)
–Regulates transcription of genes for pro-inflammatory proteins
when are all 5-ASA compounds contraindicated and when is Sulfasalazine contraindicated
All 5-ASA compounds contraindicated in ASA-allergic patients
•Sulfasalazine contraindicated in sulfonamide-allergic patients
how does administration of 5-ASA effect the extent of the disease
Oral:Varies by agent; may be released in the distal/terminal ileum, colon, or throughout GI tract
Rectal Enemas:
May reach the splenic flexure
Do not frequently concentrate in the rectum
Rectal Suppositories:
Reach the upper rectum (15-20 cm beyond the anal verge)
what are 5-ASA agents indications and what are the two exceptions
Indications (Active & Maintenance):
•Mild-to-Moderate U.C.
Except Olsalazine (only for maintenance of remission)
Except Balsalazide (only for active disease)
Mechanism of action of TNF-a Inhibitors?
Binds to an neutralizes membrane-associated and soluble human TNF-α-mediated pro-inflammatory cell signaling, ultimately blocking leukocyte migration to site of inflammation:
what is the only TNF-a inhibitor that can be given IV for IBD
Infliximab
what are side effects of TNF-a inhibitors?
Infections make sure to test for TB pre therapy since can activate from latent phase especially Adalimumab
can cause Liver toxicity
can cause Dermatologic-related (EM, SJS, TEN)
Malignancies (various)