IBS & IBD

Question 1

What class of drug is Sulfasalazine?

Answer 1

It is an aminosalicyte.

Question 2

T or F: Sulfasalizine inhibits leukotriene and lipoxygenase synthesis which will decrease inflammation

Answer 2

True

Question 3

Indications for Sulfasalazine

Answer 3

prolongation of remission in CD, adjunct in UC

Question 4

CI for Sulfasalazine?

Answer 4

history of salicylate or sulphonamide sensitivity, existing gastric or duodenal ulcers

Question 5

What drug has these DI? Digoxin/folate, iron, methotrexate/phenytoin, warfarin, sulphonylureas

Answer 5

Sulfasalazine

Question 6

What are the A/E of Sulfasalazine?

Answer 6

N&V, diarrhoea, anorexia, reversible oligosperma and infertility in males

Question 7

What drug class does Mesalazine belong to?

Answer 7

It is an aminosalicyte

Question 8

What is the I for mesalazine?

Answer 8

Tx and maintenance of remission in UC

Question 9

T or F: Mesalazine CI include history of salicyte sensitivity and renal impairment

Answer 9

True

Question 10

What are the DI of Mesalazine?

Answer 10

preparations which lower pH of stool or prevent release of active ingredient

Question 11

A/E of mesalazine: abdmn pain, N, colic, D, headache

Answer 11

True

Question 12

What are some examples of corticosteroids used in IBS/IBD Tx?

Answer 12

Prednisone, methylprednisone, hydrocortisone (budesonide administered rectally or in controlled release formulation)

Question 13

I for corticosteroids in IBS/IBD?

Answer 13

Treat relapses, acute phase

Question 14

What immunosuppressants are used in IBS/IBD?

Answer 14

Azathioprine, Mercaptopurine, Methotrexate, Cyclosporin: Azathioprine and Meracaptopurine used for long term Tx of CD and UC

Question 15

What are the I for immunosuppressants in IBS/IBD?

Answer 15

Reserved for pts who fail on aminosalicytes or refractory to or dependent on corticosteroids

Question 16

Are any biological agents indicated for Tx in IBS/IBD?

Answer 16

Yes, Infliximab and adalimubab

Question 17

What does infliximab inhibit to decrease intestinal inflammation?

Answer 17

TNF-alpha

Question 18

I of Infliximab?

Answer 18

moderate to severe CD, fistulating CD, UC pts who do not benefit from conventional therapies

Question 19

What drug do these CI describe? active TB, sepsis, abscesses, heart failure

Answer 19

Infliximab

Question 20

What are the A/E of Infliximab?

Answer 20

viral infections, fever, headache, vertigo, N, D…….

Question 21

How does Adalimumab decrease inflammation?

Answer 21

Inhibit TNF-alpha

Question 22

T or F: Adalimumab is first line therapy

Answer 22

False. It is indicated in pts that are no longer responding to or are intollerant to infliximab

Question 23

What are the 3 types of IBS?

Answer 23

Constipation prominent IBS (IBS-C)
Diarrhoea prominent IBS (IBS-D)
Mixed bowel habits IBS (IBS-M)

Question 24

What drugs are used in the Tx of IBS-D?

Answer 24

Antidiarrheals
Loperamide, diphenoxylate, codeine
Antispasmotics
Hyoscine, mebeverine, dicyclomine
Antidepresants
TCAs, SSRIs, SNRIs

Question 25

Drugs used in IBS-C?

Answer 25

Laxatives
bulk-forming agents: psyllium husk, sterculia, methylcullulose
Propulsives: Linaclotide, lubiprostone
Osmotic agents: PEG, Mg salts