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G2F > IBD Pharm > Flashcards

IBD Pharm Flashcards

1
Q

Drug Classes for UC

A
  • 5-ASA**
  • Corticosteroids
  • TNF-alpha inhibitors
  • alpha-4 integrin inhibitors
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2
Q

Drug Classes for CD

A
  • IL-12/23 inhibitors**
  • Corticosteroids
  • TNF-alpha inhibitors
  • alpha-4 integrin inhibitors
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3
Q

UC- 5-ASA- drugs

A

-SulfaSALAzine (sulfapyridine + 5-ASA)
-MeSALAmine (single 5-ASA)
-OlSALAzine (2 molecules of 5-ASA)
-BalSALAzide (inert carrier + 5-ASA)
(SMOB)

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4
Q

UC- TNF-alpha inhibitors- drugs

A
  • AdalimuMAB
  • GolimuMAB
  • InflixiMAB
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5
Q

UC- alpha-4 integrin inhibitors- drugs

A

-VedolizuMAB

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6
Q

CD- IL-23 inhibitors- drug

A

-UstekinuMAB

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7
Q

CD- TNF-alpha inhibitors- drugs

A

(same as UC)

  • AdalimuMAB
  • GolimuMAB
  • InflixiMAB
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8
Q

CD- alpha-4 integrin inhibitors- drugs

A
  • NatalizuMAB

- VedolizuMAB (also in UC)

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9
Q

5-ASA- moa

A

-inhibition of PG and LT production via arachidonic acid pathway- COX and LIPOX

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10
Q

5-ASA- contraindications

A
  • ALL contraindicated in ASA-allergic pts

- Sulfasalazine- contraindicated in sulfonamide-allergic pts!!!

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11
Q

5-ASA agents- indications

A
  • mild to moderate Active UC
  • maintenance (of remission) of UC
  • except- Olsalazine- only maintenance
  • except- Balsalazide- only for active
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12
Q

TNF-alpha inhibitors- moa

A
  • neutralizes TNF-alpha-mediated pro-infl cell signaling

- inhibits expression of pro-infl genes

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13
Q

TNF-alpha inhibitors- SE

A
  • infections!!!

- TB testing pre-therapy!!!

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14
Q

TNF-alpha inhibitors- indications

A
  • all moderate to severe
  • Adalimumab and Infliximab- UC and CD! (All and Inclusive)
  • Golimumab- UC (doesnt start with C)
  • Certolizumab- CD (starts with C)
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15
Q

TNF-alpha inhibitors- dosing

A
  • Adalimumab- SQ- every other week
  • Infliximab- IV (starts with I)- every 8 wks
  • Golimumab- SQ- every 4 wks
  • Certolizumab- SQ- every 4 wks
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16
Q

alpha integrins- role in what?

A

lymphocyte migration!!

-alpha4B7- esp migration into GI tract

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17
Q

alpha-4 integrin inhibitors- moa

A

-limits integrin’s-associated cell adhesion, transendothelial migration, and immune cell activation within inflamed tissue

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18
Q

alpha-4 integrin inhibitors- SE

A

-infections
-PML(progressive multifocal leukoencephalopathy)!!! (esp natalizumab)- opportunistic infection of brain- risk factors: tx > 2yrs, prior immunosuppressant tx, anti-JC virus ab’s
(doctor must be in TOUCH prescribing program)

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19
Q

alpha-4 integrin inhibitors- indications

A
  • both moderate-to-severe and maintenance
  • Natalizumab- CD
  • Vedolizumab- CD and UD
20
Q

alpha-4 integrin inhibitors- dosing

A
  • Natalizumab- IV- 4 wks

- Vedolizumab- IV- 8 wks

21
Q

Interleukin (IL-12/23) inhibitors- moa

A

-bind to IL-12/23 R- inhibit signal transduction activities and production of pro-infl Th1 and Th17 cells

22
Q

Interleukin inhibitors- SE

A
  • infections!!

- TB testing pre-therapy recommended

23
Q

Interleukin inhibitors- indications

A
  • moderate-to-severe treatment resistant CD! (active and maintenance)
  • for pts intolerant or resistant to initial CD therapies, including TNF-alpha inhibitors
24
Q

Interleukin inhibitors- dosing

A
  • Ustekinumab
  • IV (single infusion)- for induction
  • SQ (every 8 wks)- for maintenance
25
Q

Steroids- indications, dosing

A
  • Acute and/or severe UC and CD uncontrolled by other conventional medications
  • LOWEST dose for SHORTEST duration possible
26
Q

IBS (irritable bowel syndrome)

A
  • constipation
  • diarrhea
  • abd pain
27
Q

Abdominal pain- use what drug class?

A 
Antimuscarinic agents!
-Hyoscyamine
-Dicyclomine
-Clidinium/Chlordiazepoxide
(HDC)
28
Q

Antimuscarinic agents- drugs

A

-Hyoscyamine
-Dicyclomine
-Clidinium/Chlordiazepoxide
(HDC)

29
Q

Antimuscarinic agents- moa

A
  • dec GI motility and spasms

* for Abd pain/spasms!

30
Q

Antimuscarinics- SE

A

classic antimuscarinics

31
Q

IBS- drug classes for diarrhea

A
  • anti-diarrheals
  • opioid agonists/antagonists
  • serotonin (5HT3) antagonists
32
Q

Anti-diarrheals- drugs

A
  • Loperamide

- Diphenoxylate

33
Q

Opioid Agonists/Antagonists- drug

A

-Eluxadoline

34
Q

Serotonin antagonists drug

A

Alosetron

35
Q

Loperamide- moa

A

-interferes with peristalsis- direct action of circular/longitudinal m’s of intestinal wall

36
Q

Diphenoxylate- moa

A
  • locally and centrally on GI smooth m cells
  • inhibits GI motility and slows excess GI propulsion
  • atropine added to discourage abuse
37
Q

Alosetron- moa

A

-blocks GI-based 5HT3 R’s

38
Q

Alosetron- SE

A

-ischemic colitis!!!

39
Q

Alosetron- indication

A
  • women with chronic, severe IBS-diarrhea, not responsive to other conventional therapies
  • Dr’s must enroll in prescribing program
40
Q

Eluxadoline- moa

A
  • agonist at opioid mu and K R’s in GI tract (slows peristalsis/delays digestion)
  • antagonist at delta opioid R’s in GI tract- secretionsdecreased
41
Q

Drug classes for Constipation

A
  • Guanylate Cyclase-C agonists

- Selective Chloride (C2) Channel Activators

42
Q

Guanylate Cyclase-C agonists- drug

A

-Linaclotide

43
Q

Selective Chloride (C2) Channel Activators- drug

A

-Lubiprostone

44
Q

Linaclotide- moa, indications

A

Guanylate Cyclase-C agonist

-for IBS-Constipation!

45
Q

Lubiprostone- moa, drug

A
  • selective Chloride (C2) Channel Activator

- IBS-Constipation (women)

G2F (17 decks)

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