IBD Treatment Drugs

Question 1

Balsalazide

Answer 1

Is 5 ASA with a sidegroup on it which is cleaved off by gut bacteria. It inhibits COX 2 especially leading to decreased prostaglandins. Is used for mild to moderate ulcerative colitis. No systemic absorption. Not effective for crohns

Question 2

Mesalamine

Answer 2

Is 5 ASA with a sidegroup on it which is cleaved off by gut bacteria. It inhibits COX 2 especially leading to decreased prostaglandins. Is used for mild to moderate ulcerative colitis. No systemic absorption. Not effective for crohns

Question 3

Olsalazine

Answer 3

Is 5 ASA with a sidegroup on it which is cleaved off by gut bacteria. It inhibits COX 2 especially leading to decreased prostaglandins. Is used for mild to moderate ulcerative colitis. No systemic absorption. Not effective for crohns

Question 4

Sulfasalazine

Answer 4

Is 5 ASA with a sidegroup on it which is cleaved off by gut bacteria. It inhibits COX 2 especially leading to decreased prostaglandins. Is used for mild to moderate ulcerative colitis. No systemic absorption. Not effective for crohns
AE: hypersensitivity reactions and altered folate absorption due to the sulfa group.

Question 5

Budesonide

Answer 5

Corticosteroid, subject to extensive first pass metabolism, has local rather than systemic effect compared to conventional steroids in a controlled release formulation. used for mild to moderate Crohns in the ileum and proximal colon.

Question 6

Prednisone

Answer 6

Corticosteroid, used in the treatment of moderate to severe IBD

Question 7

Prednisolone

Answer 7

Corticosteroid, used in the treatment of moderate to severe IBD

Question 8

Azathioprine

Answer 8

antimetabolite given in low doses for the induction and maintenance of remision of ulcerative colitis and crohns disease. Allow dose reduction and elimination of steroids.

Question 9

6-Mercaptopurine

Answer 9

antimetabolite given in low doses for the induction and maintenance of remision of ulcerative colitis and crohns disease. Allow dose reduction and elimination of steroids.

Question 10

Methotrexate

Answer 10

DHFR inhibitor, antimetabolite given in low doses for the induction and maintenance of remision of ulcerative colitis and crohns disease. Allow dose reduction and elimination of steroids.

Question 11

Infliximab

Answer 11

Anti TNF alpha drug, leads to dysregulation of TH1 response . Leads to symptomatic improvement and remission in patients with moderately severe crohn’s disease.
AE: Infections, reactivation of TB, Increased risk of lymphoma(may not be from drug)

Question 12

Natalizumab

Answer 12

Anti alpha 4 subunit of integren, used for MS and Crohns disease, reactivation of human Polyomavirus. Must stop immunosuppression and anti- TNF drugs for 2 months before starting.