IBD Treatment

Question 1

Basalazide
Mesalamine
Olsalazine
Sulfasalazine MOA?

Answer 1

5-ASA derivatives that limit absorption and decreases PGE levels do decrease inflammation

Question 2

What is specific about Basalazide and Sulfasalazine in terms of absorption?

Answer 2

They are metabolized by gut bacteria and are only activated in the Large intestine

Question 3

Which type of ASA are activated specifically in the ileum?

Answer 3

pH dependent ASA

Question 4

What is the main use for 5-ASA derivatives?

Answer 4

1st line against mild ulcerative colitis

Question 5

Which 5-ASA derivative has the worst toxicity including BM suppression and hypersensitivity?

Answer 5

Sulfasalazine

Question 6

When do you use prednisone/prednisolone vs. Budesonide?

Answer 6

Prednisone = Moderate to Severe IBD
Budesonide = mild to moderate Crohn's involving the ileum and proximal colon

Question 7

When would you give 5MP, methotrexate, or azathioprine?

Answer 7

Low Dose maintenance to reduce glucocorticoid use

Question 8

Inflixumab MOA?

Answer 8

Anti-TNFa

Question 9

Adalimumab MOA?

Answer 9

Anti-TNFa

Question 10

Influxumab use?

Answer 10

Severe Crohns

Question 11

SE of Influxumab?

Answer 11

Infection
Acute Fever/Chills
Severe Hepatic RXN

Question 12

Natalizumab MOA?

Answer 12

Inhibits adhesion via integrin:selectin interactions

Question 13

Natalizumab use?

Answer 13

Severe Crohn’s

Multiple Sclerosis

Question 14

SE of Natalizumab?

Answer 14

Infusion rxn

Re-activation of human polyomavirus