IBS & IBD Flashcards
What class of drug is Sulfasalazine?
It is an aminosalicyte.
T or F: Sulfasalizine inhibits leukotriene and lipoxygenase synthesis which will decrease inflammation
True
Indications for Sulfasalazine
prolongation of remission in CD, adjunct in UC
CI for Sulfasalazine?
history of salicylate or sulphonamide sensitivity, existing gastric or duodenal ulcers
What drug has these DI? Digoxin/folate, iron, methotrexate/phenytoin, warfarin, sulphonylureas
Sulfasalazine
What are the A/E of Sulfasalazine?
N&V, diarrhoea, anorexia, reversible oligosperma and infertility in males
What drug class does Mesalazine belong to?
It is an aminosalicyte
What is the I for mesalazine?
Tx and maintenance of remission in UC
T or F: Mesalazine CI include history of salicyte sensitivity and renal impairment
True
What are the DI of Mesalazine?
preparations which lower pH of stool or prevent release of active ingredient
A/E of mesalazine: abdmn pain, N, colic, D, headache
True
What are some examples of corticosteroids used in IBS/IBD Tx?
Prednisone, methylprednisone, hydrocortisone (budesonide administered rectally or in controlled release formulation)
I for corticosteroids in IBS/IBD?
Treat relapses, acute phase
What immunosuppressants are used in IBS/IBD?
Azathioprine, Mercaptopurine, Methotrexate, Cyclosporin: Azathioprine and Meracaptopurine used for long term Tx of CD and UC
What are the I for immunosuppressants in IBS/IBD?
Reserved for pts who fail on aminosalicytes or refractory to or dependent on corticosteroids
Are any biological agents indicated for Tx in IBS/IBD?
Yes, Infliximab and adalimubab
What does infliximab inhibit to decrease intestinal inflammation?
TNF-alpha
I of Infliximab?
moderate to severe CD, fistulating CD, UC pts who do not benefit from conventional therapies
What drug do these CI describe? active TB, sepsis, abscesses, heart failure
Infliximab
What are the A/E of Infliximab?
viral infections, fever, headache, vertigo, N, D…….
How does Adalimumab decrease inflammation?
Inhibit TNF-alpha
T or F: Adalimumab is first line therapy
False. It is indicated in pts that are no longer responding to or are intollerant to infliximab
What are the 3 types of IBS?
Constipation prominent IBS (IBS-C)
Diarrhoea prominent IBS (IBS-D)
Mixed bowel habits IBS (IBS-M)
What drugs are used in the Tx of IBS-D?
Antidiarrheals
Loperamide, diphenoxylate, codeine
Antispasmotics
Hyoscine, mebeverine, dicyclomine
Antidepresants
TCAs, SSRIs, SNRIs
Drugs used in IBS-C?
Laxatives
bulk-forming agents: psyllium husk, sterculia, methylcullulose
Propulsives: Linaclotide, lubiprostone
Osmotic agents: PEG, Mg salts
