IBD drugs Segars Flashcards
which ASA is used only for maintence therapy in UC
olsalazine
which a-4 integrin inhibtor is administered less often
vedolizumab
agents for UC categories
5-ASA (sala)
corticosteroids
TNF-a inhibtors (mab) (Golimumab)
a-4 integrin inhibitors (vedolizumab)
side effects of eluxadoline
GI related
hepatic/pancreatic toxicity
CNS related
alosetron indication
women with chronic, severe IBS-D not responsive to other conventional therapies
a-4 integrin inhibitors mechanism of action
limits integrin associated cell adhesion
loperamide MOA
for diarrhea
interferes with peristalsis by direct action on circular and longitudinal muscles of intestinal wall, slowing motility
-may also directly inhibit fluid and electrolyte secretion and or increase water absorption
side effects of alosetron
constipation
ischemic colitis
indications for a-4 integrin inhibitors
moderate to severe treatment resistant CD and UC and maintenance therapy to prevent relapse
uses of interleukin IL-12/23 inhibitors
moderate to severe treatment resistant CD (active and maintenance)
MOA for 5-ASAs
block COX and LIPOX which decreases PG and LT
uses of 5-ASA agents indications
mild to moderate active UC and maintenance of remission of UC
ustekinumab is what
MOA
interleukin IL-12/23 inhibitor
bind to specific subunit of IL-12/23 receptor located on surface of T cells and natural killer cells
-stops signal transduction and production of proinlfamm th1 and th17 cells
lubiprostone
activates specific CIC-2 chloride channels in luminal cells of intestinal epitheliumv = chloride rich intestinal fluid secretion
- prostaglandin E-1 derivative
- lube up the intestine
which of the 5-ASAs has 2 molecules of 5-ASA
olsalazine
which of the 5-ASAs have side effects
sulfasalazine
diphenoxylate
for what, moa
what is added to discourage abuse
side effects
diarrhea with IBS
works on GI SM cells, inhibts motility and slows excess GI propulsion
atropine added
SE: constipation, dizziness, drowsiness, urinary retetnion
which 5-ASA is used only for treatment of active disease UC
balsalazide
which TNF-a inhibitor is a FAb’
what are the rest
certolizumab is a Fab
rest are IgG monoclonal antibody
alosetron
for IBS-D
blocks 5HT3 receptors
side effect of interleukin IL-12/23 inhibitor
infections
-TB testing pre-therapy recommended
lubiprostone SE
nausea, dyspepsia, dizziness
uses of steroid agents
acute and or severe UC and CD uncontrolled by other conventional meds
IBS drug class for abdominal pain
antimuscarinics
- hyoscyamine
- dicyclomine
- clidinium/chlorodiazepoxide
agents for CD
IL-12/23 inhibitors (ustekinumab)
corticosteroids
TNF-a inhibitors (mab) (certolizumab)
a-4 integrin inhibitors (natalizumab and vedolizumab)
side effects of linaclotide
diarrhea, abd pain
don’t use under 17 yrs old
linaclotide
for IBS-C
moa: binds to guanylate cyclase C on luminal surface of intestinal epithelium (agonist)
- stimulates secretion of chloride/bicarb into intestinal lumen via activation of CFTR which results in increased intestinal fluid and accelerated transit
tide of fluid
eluxadoline
agonist at opiod mu and kappa receptors in GI tract
antagonist at delta opooid receptors
side effects of a-4 integrin inhibitors
infections
- PML
- 3 risk factors
- treament over 2 yrs, prior immunosupp therapy, anti-jc virus antibodies
side effects of TNF-a inhibitors
infections (especially adalimumab)
TB testing pre-therapy
which a-4 integrin inhibitors are used for chrons
natalizumab and vedolizumab
my chronnies are in NV
dosing of TNF-a inhibitors, which one is given IV
what about the rest
infliximab is given IV
the rest are given SQ
lubiprostone indications
IBS-C (women)
chronic idiopathic constipation
uses of TNF-a inhibitors
tx of active and maintence
moderate to severe disease, not mild
AE glucocorticosteroids
increase glucose, bp, and lipid profile gi distress fluid retetnion increased appetite/fat redistribution bone defects insomnia
side effect of loperamide
constipation, dizziness, drowsiness, urinary retention
