IBD tx Flashcards
agents for UC
5-ASA
corticosteroids
TNFa Inhibitors
a4 integrin inhibitors
Corticosteroids
prednisone dexamethasone hydrocortisone methylprednisone MOA: - inhibit leukocyte infiltration at site of inflammation - suppress humoral response
5-ASA
sulfasalazine mesalamine olsalazine balsalazide inhibit COX and LIPOX - reduces PMN and macrophage chemotaxis and NFkB contraindicated in: - asa allergic pts - sulfasalazine contraindicated with sulfonamide-allergic pts
TNFa inhibitors
adalimumab golimumab (UC) infliximab certolizumab (CD) TB testing pre-therapy! liver toxicity, headache, arthralgia, fatigue, malignancies
a4 integrin inhibitors
vedolizumab Natalizumab (CD)
IL-12/23 inhibitors
ustekinumab MOA: - inhibits production of Th1 and Th17 Side effects: - TB infection -rare increased risk of malignancy
agents for CD
IL12/23 inhibitors
corticosteroids
TNFa inhibitors
a4 integrin inhibitors
5-ASA indications
moderate/mild active UC and maintenance
olsalazine
only for maintenance of UC
Balsalazide
only for active UC
TNFa inhibitor indications
active and maintenance
a4 integrin inhibitor side effects
infections PML from JC virus risk factors (Natalizumab) - treatment >2years - prior immunosuppressant treatment - anti JC virus antibodies
a4 integrin indications
moderate to severe treatment resistant CD and UC (vedolizumab)
moderate to severe treatment resistant CD and maintenance (natalizumab)
don’t take with TNFa inhibitors
IL12/23 inhibitors indications
moderate to severe treatment resistant CD for active and maintenance
indicated in those resistant to prior tx w/ TNFa inhibitors
Glucocoritcosteroid adverse effects
increase glucose, BP and lipid profile GI distress (N/V, ulcerations) fluid retention and edema insomnia, nervousness, osteopenia/porosis
