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Pharmacy > Inflammatory Bowel Disease > Flashcards

Inflammatory Bowel Disease Flashcards

1
Q

these drugs can cause IBD

A

opiates, NSAIDs, antidiarrheals (loperamide, diphenoxylate/atropine)

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2
Q

pt with UC isnt getting many leafy veggies and is taking sulfasalazine. What should you prescribe

A

Folic acid

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3
Q

pt with UC is having considerable rectal bleeding. What should you prescribe?

A

Oral iron

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4
Q

a pt had mild/mod UC but now has mod/severe. What changes in their drug regimen

A

add prednisone (HUGE DOSE)

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5
Q

pt is refractory severe UC. what can i add?

A

azathioprine or mercaptopurine 6MP

or infliximab if no response

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6
Q

fulminant UC. How does therapy change?

A

hydrocortisone 100mg

if no response, cyclosporine or colectomy

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7
Q

Maintenance options for UC

A

aminosalicylates and/or AZA or 6-MP

or infliximab

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8
Q

m/m ileocolonic or colonic crohn tx

A

sulfasalazine

mesalamine

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9
Q

m/m perianal crohn tx

A

sulfasalazine
mesalamine
metronidazole

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10
Q

m/m small bowel crohn tx

A

mesalamine
metronidazole
budesonide (steroid)

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11
Q

m/s crohn tx what changes

A

follow the m/m protocol but add prednisone
add infliximab if refractory or fistulating
no response: add adalimumab, natalizumab, certolizumab

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12
Q

severe/fulminant crohn tx

A

hydrocortizone
no response- cyclosporin
surgical resection

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13
Q

do not use long term corticosteroids for maintenance of crohn. T or F

A

True

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14
Q

first line for maintenance of crohn

A

azathioprine/6-MP
(infliximab)
(methotrexate)

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15
Q

this class is commonly used for inducing and maintaining remission of IBD

A

aminosalicylates

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16
Q

this drug is metabolized by intestinal bacteria to 5-aminosalicylate and suldapyridine (mesalamine)

A

sulfasalazine

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17
Q

this drug is contraindicated in patients with renal impairment (monitor SCr) and in pts with salicylate hypersensitivity

A

sulfasalasine

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18
Q

this drugs SE include N/V heartburn, anorexia, HA, hypersensitivity rxns, blood disorders, folic acid absorption, idiosyncratic rxns (HC injury, agranulocytosis, lupus-like pneumonia), and low sperm counts

A

sulfasalasine

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19
Q

it is mandatory to prescribe a folic acid supplement with this drug

A

sulfasalasine

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20
Q

this drug comes in different formulations so it can better target parts of the colon (suppositories or delayed release formations)

A

mesalamine

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21
Q

SEs include local itching and mild rectal irritation with topical enemas and idiosyncratic reactions (pleuropericarditis, pancreatitis, nephrotic syndrome)

A

mesalamine

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22
Q

these drugs have anti-inflammatory effects to improve symptoms and decrease disease severity

A

corticosteroids

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23
Q

induction of response takes 7-14 days for this drug. it is important to taper

A

corticosteroids

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24
Q

a patient on this class of drug should be monitored for complications of glucose intolerance/metabolic abnormalities (hyperkalemia, hyponatremia, glucose)

A

corticosteroids

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25
Q

pts taking this class have greater risk for adrenal insufficiency and infections. N/V, postural hypotension

A

corticosteroids

26
Q

If a pt is on this class for over 3 months, monitor bone density and do annual eye exams

A

corticosteroids

27
Q

this is a prodrug that gets metabolized to 6-mercaptopurine

A

azathioprine

28
Q

this class provides maintenance therapy that is less toxic than chronic steroid therapy

A

immunosuppressives

29
Q

this class antagonizes purine metabolism; inhibit DNA, RNA and protein synthesis

A

immunosuppressives

30
Q

toxic levels of this drug class can cause bone marrow suppression (dose related), lymphoma, pancreatitis, GI effects, fever, rash, arthralgias

A

immunosuppressives

31
Q

this class can cause disseminated CMV, herpes zoster, pneumonia, Q fever, viral hepatitis

A

immunosuppressives

32
Q

this class can react with other drugs leading to increased myelosuppression: sulfasalazine, mesalamine, allopurinol, aspirin, furosemide

A

immunosuppressives

33
Q

this dug is a folic antagonist with anti-inflammatory effects. It reduces the need for steroids and improves disease control

A

methotrexate

34
Q

ADRs include nausea and ELEVATED TRANSAMINASES (MONITOR LFT)

A

methotrexate

35
Q

toxic levels of this drug can cause leukopenia, N/V, hypersensitivity pneumonitis, hepatic fibrosis

A

methotrexate

36
Q

this drug is an absolute contraindication in pregnancy (categoryX). stop therapy 3 months prior to conception

A

methotrexate

37
Q

this drug inhibits production and release of IL-2 and inhibits activation of T lymphocytes

A

cyclosporin (neoral or sandimmune)

38
Q

this drug is unable to maintain remission alone. It requires “bridging” with AZA or 6-MP and is recommended to be used concomitantly with IV steroids

A

cyclosporin (neoral or sandimmune)

39
Q

toxic levels of this drug can cause HTN, hypertrichosis, electrolyte abnormalities, nephrotox, and opportunistic infections (REQUIRES PCP prophylaxis)

A

cyclosporin

40
Q

this drug comes from a fungus and inhibits T lymphocyte activation

A

tacrolimus

41
Q

ADRs for this drug tend to be dose related. Include HA, increased serum creatinine, nausea, insomnia, leg cramps, paresthesias, and tremors

A

tacrolimus

42
Q

this drug is a monoclonal antibody that binds to TNF-alpha. It inhibits inflammatory cytokines, leukocytes migration, and activation of neutrophils

A

Infliximab

43
Q

Contraindicated in class III/IV heart failure and hepatitis (DC with LFTs 5x ULN)

A

Infliximab

44
Q

Your body will develop antibodies to this drug, which leaves an increased risk of infusion reaction and a shorter duration or response

A

infliximab

45
Q

toxic levels of this drug lead to infections (bacterial mycosal mycobacterium) and infusion reactions (NOT through an IgE and NOT at every infusion)

A

infliximab

46
Q

this drug can cause delayed hypersensitivities 3-14 days after infusion that include myalgia, arthralgia, fever, rash, pruritis, urticaria, HA. Can treat with steroids

A

infliximab

47
Q

a risk factor for toxic effects with this drug includes long intervals between treatments

A

infliximab

48
Q

This drug can cause malignancy and lymphoproliferatve disorders in pts with longstanding Crohns who are immunosuppressed

A

infliximab

49
Q

this drug is a fully human immunoglobulin 1 anti TNF alpha monoclonal antibody

A

adalimumab

50
Q

evaluate for TB before starting therapy with this drug

A

adalimumab

51
Q

this drug has a BBW for causing serious infections (TB, invasive fungal)
it can cause rash, HA, urticaria, development of autoantibodies
risk or reactivating hep B

A

adalimumab

52
Q

this drug is for moderate to severe crohns in pts with evidence of inflammation who have had inadequate response to or are unable to tolerate conventional therapies

A

natalizumab

53
Q

this drug is for pts in a specialty program. It is a recombinant immunoglobulin 4 monoclonal antibody

A

natalizumab

54
Q

dont administer this drug with other immunosuppressants. You should DC if no response in 12 weeks and taper oral steroids as soon as there is a response

A

natalizumab

55
Q

major adverse effect of this drug includes progressive multifocal encephalopathy

A

natalizumab

56
Q

this ab is used for treatment of ileocolitis or colitis if there was failure to respond to sulfasalazine

A

metronidazole

57
Q

ADRs include GI upset, metallic taste, paresthesias, antabuse-like rxn

A

metronidazole

58
Q

this ab is effective in resistant disease when used in combo with standard treatment

59
Q

this ab combo can be used to improve and promote closure of fistulas

A

metronidazole plus cipro

60
Q

this class can provide symptomatic relief of diarrhea by inhibiting excessive GI motility or propulsion

Pharmacy (22 decks)

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