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GI Week 2 > IBD Pharma > Flashcards

IBD Pharma Flashcards

1
Q

what is the order of medicine for IBD in terms of what you give from mild to severe IBD?

A

aminosalicylates to thiopurines to biologics for most severe

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2
Q

what class of drugs can you only give as short term bridge or induction therapy?

A

steroids

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3
Q

why do you need to taper off steroids?

A

to avoid adrenal insufficiency

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4
Q

what is the oral steroid for IBD?

A

prednisone

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5
Q

what is the gut targeted steroid for IBD?

A

budesonide

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6
Q

what are the topical steroid options for IBD?

A

suppository
rectal form
enema

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7
Q

when should you give topical steroids over other steroid types?

A

if disease located only in rectum

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8
Q

what are the two side effects of steroids for IBD?

A

osteoporosis and lots of infections

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9
Q

what is the structure of aminosalicylate similar to?

A

aspirin

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10
Q

is aminosalicylate used for UC or crohns or both?

A

used in UC

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11
Q

how do aminosalicylates usually work in the GI tract?

A

anti inflamm agents…mechanism unknown but gues sof inhib prostaglandins and leukotrienes

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12
Q

what are the two ways to give aminosalicylate ?

A

oral or rectal topical form

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13
Q

are thiopurines used for UC crohns or both?

A

both

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14
Q

are thiopurines used for maintenance induction or both?

A

maintenance only…takes a long time to get working

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15
Q

are aminosalicylate used for maintenance induction or both?

A

both

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16
Q

name the two thiopurines to know

A

azathioprine and 6mercaptopurine

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17
Q

what is the MoA of thiopurines?

A

block purine synthesis and inhibit proliferation of B and T cells in the immune system

18
Q

name the four toxicities associated with thiopurines? which two need to be checked consistently

A

hepatotxicity (check)
bone marrow suppression (check)
pancreatitis
cancer

19
Q

what is a drug that is similar to thiopurines but not used as often? why is it not used as much?

A

methotrexate…teratogenic

20
Q

what is the mechanism of methotrexate?

A

blocks purine synthesis…

21
Q

do you use methotrexate with Crohns UC or both?

A

can use for both..better for Crohns

22
Q

what can happen with biologics that renders them ineffective/

A

immunogenecity…means the body makes an antibody against the antibody in the biologic

23
Q

name the three anti TNF drugs used for IBD

A

infliximab
adalimumab
certolizumab

24
Q

is infliximab used for crohns UC or both?

A

both

25
Q

is adalimumab used for crohns UC or both?

A

UC only

26
Q

is certolizumab used for crohns UC or both?

A

crohns only

27
Q

how do the anti TNF biologics work?

A

they likely inhibit activation of T cells in the gut

28
Q

do you use TNF bios for induction maintenance or both?

A

both

29
Q

when do you give TNF bios, for crohns of UC? what stage?

A

Both…moderate to severe

30
Q

name the four common toxicities of TNF bios

A

infection
reactivation of TB or hep B
malignancy
exacerbation of heart failure

31
Q

what is the MoA of vedolizumab?

A

it is an inhibitor of integrins so the leukcytes cannot bund the selectins in the gut and migrate into the tissue

32
Q

name the drug that is an integrin inhibitor biologic

A

vedolizumab

33
Q

when do you give vedolizumab, maintenance induction or both? crohns UC or both?

A

both and both

34
Q

what are the toxicities of vedolizumab?

A

minimal because gut targeted…so gut infections

35
Q

name the drug that inhibits the p40 receptor?

A

Ustekinumab

36
Q

the p40 receptor that ustekinumab inhibits, leads to inhibition of what? what are these molecules important for?

A

IL-12 and 23..important for the JAK STAT pathway

37
Q

ustekinumab is used for crohns, UC or both? maintenanc induction or both?

A

just crohns…both

38
Q

what is the toxicity of ustekinumab?

A

just systemic immune supression

39
Q

what drug is a small molecule (not antibody) that inhibits the JAK STAT pathway?

A

tofacitinib

40
Q

what do you use tofacitinib for? UC crohns or both? maintenanc induction or both?

A

just UC…both

41
Q

what are the four toxicities of tofacitinib?

A

elevated cholesterol
lymphpenia
elevated LFTs
systemic immune suppression

GI Week 2 (12 decks)

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