IBD Drugs

Question 1

5-ASA agents for UC

Answer 1

“sala”

1. Sulfasalazine
2. Mesalamine
3. Olsalazine
4. Balsalazide

Question 2

JAK inhibitor for UC

Answer 2

Tofacitinib (Xeljanz)

Question 3

IL-12/23 Inhibitor for UC and CD

Answer 3

Ustekinumab (Stelera)

- Used in psoriatic arthritis as well

Question 4

TNF-a Inhibitors for UC and CD

Answer 4

Adalimumab

Infliximab

Question 5

TNF-a Inhibitors for UC ONLY

Answer 5

Golimumab

Question 6

TNF-a Inhibitors for CD ONLY

Answer 6

Certolizumab

Question 7

a-4 Integrin Inhibitor for UC and CD

Answer 7

Vedolizumab

“Hold up 2 fingers (CD+UC) and it makes a V

Question 8

a-4 Integrin Inhibitor for CD ONLY

Answer 8

Natalizumab

Question 9

How do the 5-ASA’s work?

Answer 9

COX inhibitors that decrease PG and LT production which leads to decreased PMN and Mo chemotaxis.
May also inhibit NFKB

Question 10

A patient presents with pyoderma gangrenosum and Uveitis. She states she is allergic to sulfa drugs. What first line drug do you NOT prescribe for her most likely diagnosis?

Answer 10

Sulfasalizine (UC)

Question 11

What reported allergy would make the 5-ASA drugs contraindicated?

Answer 11

Aspirin allergy

Question 12

A patient presents with hematochezia, LLQ pain, and on endoscopy shows pseudo polyps. Which 5-ASA drug is NOT included in your plan?

Answer 12

Olsalazine- maintenance only

Question 13

How do the TNF-a inhibitors work?

Answer 13

Bind to and inhibit soluble and transmembrane TNF-a

Question 14

Which TNF-a inhibitor does not have an Fc portion?

Answer 14

Certolizumab

Question 15

What test must be done prior to administration of a TNF-a inhibitor?

Answer 15

TB test.

Could be latent, don’t want to reactivate

Question 16

How do a-4 integrin inhibitors work?

Answer 16

Inhibit binding of leukocytes to epithelial cells thus preventing transmigration

Question 17

What infection must be monitored as a possible side effect of natalizumab?

Answer 17

Progressive Multifocal Leukoencephalopathy

Question 18

MOA of IL-12/23 inhibitors

Answer 18

bind p40-subunit of the interleukin to block it’s activation effect on T-cells

Question 19

JAK Inhibitors MOA

Answer 19

Prevent binding and phosphorylation of STAT cascade which decreases pro-inflammatory gene transcription

Question 20

What is usually a part of IBD treatment that is not covered in this section but still important?

Answer 20

Corticosteroid administration