Inflammatory Bowel Disease (IBD) Flashcards

1
Q

What 2 diseases make up Inflammatory Bowel Disease (IBD)

A

Crohn’s and ulcerative colitis are both diseases in IBD

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2
Q

IBD: Goals of Treatment

4

A

No cure

  • Suppress inflammatory response–Chronic inflammation can cause permanent damage
  • Induce remission
  • Prevent complications
  • Maintain remission
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3
Q

IBD: Drug Classes (5)

A
  • 5-aminosalicylic acid derivatives (5-ASA)
  • Steroids: topical and systemic
  • Antibiotics
  • Immunomodulators
  • Biologics
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4
Q

what is 5-ASA MOA?

A

o Decrease PG and leukotriene synthesis
o Inhibit cytokine synthesis
o Free radical scavenging
o Immunosuppressive activity

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5
Q

IS 5-ASA mainly for UC or Chron’s

A

UC

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6
Q

5-ASA Drug products (4)

A

o Sulfasalazine
o Mesalamine: actual 5-ASA moiety
o Olsalazine (Dipentum)
o Balsalazide (Colazal)

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7
Q

5-ASA: ADRs

A
  • Worse with sulfasalazine but any can have
  • Idiosyncratic: hypersensitivity rash, fever, pancreatitis, bone marrow suppression, hepatitis
  • Dose-related: n/v/d, HA, anorexia, dyspepsia
  • Sulfasalazine: oligospermia (reversible)-means low sperm count
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8
Q

oligospermia is associated with what 5-ASA?

A

Sulfasalazine

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9
Q

if pts have ADRs on 5-ASA should you rechallenge the medication?

A

no

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10
Q

What are corticosteroids mainly used for in Inflammatory Bowel Disease

A

Mainly used to induce remission during acute episodes

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11
Q

should you use topical corticosteroids in chron’s or UC

A

UC

Can’t do topical if problem is in small intestine, usually do per rectum for UC

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12
Q

For UC flares, best to try ______ application if patient tolerates

A

intraluminal

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13
Q

what is the drug name of the corticosteroid commonly used for IBD

A

Budesonide (Entocort)

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14
Q

what is the formulation of Budesonide (Entocort)

A

controlled ileal release formulation

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15
Q

Antibiotics helped with what in IBD?

A

Helps with acute flares

Good for septic complications and some for primary disease processes

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16
Q

What antibiotics are commonly used in combination to treat IBD

A

Metronidazole + ciprofloxacin

17
Q

Rationale for using antibiotics in IBD

A

o Decrease concentrations of bacteria in gut lumen
o Alter composition of gut flora
o Decrease bacterial tissue invasion and treat microabscesses
o Decrease bacterial translocation

18
Q

When is Immunomodulator Therapy used in IBD?

A

Used for refractory disease

19
Q

what are the drug names of the Immunomodulators

A
  • Azathioprine (AZA): prodrug of 6-MP
  • 6-mercaptopurine (6-MP)
  • Methotrexate
20
Q

MOA of Immunomodulators

A

DNA synthesis inhibitors

21
Q

Immunomodulators ADRs

A

o Bone marrow suppression, liver dysfunction, hypersensitivity reactions, nausea
o Increased risk for infections and cancer

22
Q

Biologics drug names all end in

A

MAB

23
Q

Biologics: ADRs

A
  • Injection site/infusion reactions
  • Neutropenia
  • Infections
  • Heart failure
  • Malignancy
  • Demyelinating disease