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Phar 504 > Inflammatory Bowel Disease > Flashcards

Inflammatory Bowel Disease Flashcards

1
Q

What is the difference between Inflammatory Bowel Disease and Irritable Bowel Syndrome

A

IBD is Immune mediated resulting in chronic inflammation and ulceration of the GI tract while IBS is a functional disorder of the GI tract

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2
Q

What are the two main IBD diseases

A

Crohn’s Disease and Ulcerative Colitis

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3
Q

What are the two age gaps these diseases culminate

A

13-39, 60-80

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4
Q

What are the IBD risk factors

A

sedentary lifestyle, stress, vitamin D deficiency , NSAIDS and oral contraceptives, family history

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5
Q

What is the best way to diagnose IBD

A

Endoscopy with biopsy

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6
Q

How far does a colonscopy go, what does it look at

A

5 feet, large intestine

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7
Q

How far does a sigmoidiscopy go, what does it look at

A

2 feet, descending colon

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8
Q

What is the disease location, endoscopic visualization, and pathology of Crohn’s Disease

A

mouth to rectum, deep inflammation (cobblestone), granulomas and inflammation with lymphoid aggregates

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9
Q

What is the disease location, endoscopic visualization, and pathology of Ulcerative Colitis

A

confined to the colon, superficial inflammation and erythema, crypt atrophy and neutrophil infiltration

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10
Q

What serologic marker is used to distinguish ulcerative colitis and Crohn’s Disease

A

Antibody tests

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11
Q

What are the 4 sub categories of ulcerative colitis

A

proctitis: inflammation of the rectum, proctosigmoiditis: inflammation of rectum and sigmoid colon, distal disease: inflammation that extends to splenic flexure, pancolitis: inflammation that extends past splenic flexure

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12
Q

What are the 6 sub categories of Crohn’s disease

A

ileocolitis: inflammation in the illieum and colon, ileitis: illeum, gastroduodenal: stomach and duodenum, jejunoileitis: jejenum and illieum, granulomatous: whole colon, perianal: only in the rectum

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13
Q

What is the most common sub categorie of Crohn’s disease

A

ileocolitis

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14
Q

What are Crohn’s Disease complications

A

fistulas: unneeded pathway, abscesses: pockets of infection, fissures, nutritional deficiencies

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15
Q

What is extraintestinal manifestation

A

inflammation in other organ systems

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16
Q

What is severe fulminant of crohn’s disease

A

persistent symptoms despite treatment or high temperatures, persistent vomiting, intestinal obstruction, cachexia or abscess

17
Q

What are the first line drugs of mild to moderate Ulcerative Colitis why

A

aminosalicylates, induce and maintain remission

18
Q

What are the two main functions of aminosalicylates

A

anti-inflammatory and immunosuppresive

19
Q

What is the active drug of sulfasalazine, what causes the side effects

A

mesalamine (5-ASA), sulfapyridine

20
Q

Where do the aminosalicylate formulations work

A

Colon

21
Q

What are important adverse effects of Sulfasalazine

A

Male inferetility (reversible), may turn urine orange, may stain contacts and cause yellow tears

22
Q

T/F: One gram of Folic acid must be taken with sulfasalazine

A

True

23
Q

What are side effects of balsalazide and olsalazine

A

headache, nausea, abdominal pain

24
Q

When should a patient be switched to a mesalamine agent when taking balsalazide or olsalazine

A

When watery diarrhea is present

25
Q

Which mesalamine agent is an enema and where is the site of action, how should it be taken

A

Rowasa, Descending colon and recteum, given at bedtime and lay on left side for 8 hours

26
Q

What is the formulation of Canasa, where is the site of action, when should it be taken

A

Suppository, rectum, after a bowel movement

27
Q

Which mesalamine agent is a oral formulation and works in the small bowel and colon

A

Pentasa

28
Q

What is site of action and formulation of Apriso

A

Jejunum to colon, oral

29
Q

Which mesalamine agents are oral formulations and work in the terminal ileum to colon

A

Asacol, Delzicol, Lialda

30
Q

When should mesalamine be discountinued

A

if pancreatitis, pneumonitis, or nephrotoxicity is present

31
Q

What should be monitored for sulfasalazine

A

CBC and LFTs at initiation of therapy, every 2 weeks for 3 months, every month for 3 months, then every 3 months

32
Q

What should be monitored for mesalmine agents

A

serum creatinine at 6 weeks, 6 months, 12 months then annually

33
Q

What are corticosteroids used for in IBD

A

treatment of active UC or CD and/or failed 5-ASA therapy

34
Q

Which steroid product has an oral formulation and is the go to for CD and UC

A

prednisone

35
Q

When would budesonide become the preferred steroid

A

symptoms are mild-moderate and long term steroids

36
Q

What are the two formulations of budesonide and where do the work

A

Entocort EC- terminal ileum, ileum, ascending colon/ Uceris- Colon

Phar 504 (34 decks)

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