IBD/IBS/CIC Pharm Flashcards
What disease are 5-ASA products used for and what is the suffix?
Ulcerative colitis
-azine
What 5-ASA drugs are used only for maintenance and treatment of active disease, respectively?
Olsalazine–> only for UC maintenance/remission
Balsalazine–> only for UC active disease tx
Both indicated for mild-to-moderate UC
What 5-ASA drugs are contraindicated for people with drug allergies?
Sulfasalazine–> C/I for people with sulfa allergy **
All 5-ASA drugs C/I in people with aspirin allergies
Most TNF-a inhibitors are used for both UC and CD. Which ones can only be used for one or the other?
Certolizumab–> moderate-to-severe CD only
Golimumab-> moderate-to-severe UC only
What is the black box warning for TNF-a inhibitors?
Infections are high-risk and a major concern **
What are the TNF-alpha inhibitors?
All Monoclonal AntiBodies (-mab)
Adalimumab, Infliximab, Golimumab(UC), Certolizumab (CD)
What are the Alpha-4 Integrin inhibitors and their indications?
Natalizumab: moderate-to-severe treatment-resistant CD
Vedolizumab: moderate-to-severe treatment-resistant CD and UC
What are the adverse effects of the Alpha-4 Integrin inhibitors?
Infections **
Black box warning: Progressive Multifocal Leukoencephalopathy (PML)
What GI problem would you use antimuscarinics for?
IBS spasms and abdominal pain
What is the use of Loperamide?
Anti-diarrheal
Slows intestinal motility (chemically related to opioids but NO opioid action)
What drug could you use for diarrhea that does not have anti-cholinergic side effects?
Alosetron (5HT3 antagonist)
What is a serious complication of Alosetron?
Ischemic colitis: Black Box warning **
What drug used for IBS-C and CIC has the same MOA as the ETEC heat-stable toxin?
Linaclotide
Both increase cGMP–> secretion of Cl/HCO3 into lumen–> increased intestinal fluid
What Cl-channel activator is indicated for opioid induced constipation?
Lubiprostone
When should you take bulk-forming agents?
It doesn’t matter, just don’t take them within 1-2 hours of other drugs because they have LOTS of interactions
If stimulants are causing abdominal cramping, what drug class could you use that causes less abdominal cramping?
Stool softeners
Dolcusate salts and Mineral oil
Which osmotic agent is used for severe liver disease? How does it help?
Lactulose (for hyperammonemia) **
Changes pH and traps ammonia in GI tract
What drugs are indicated for pre-colonoscopy only?
Prepopik (Na Picosulfate), and large doses of PEG-3350 **
