Management of IBD Flashcards
IBD characteristics
Ulcerative colitis + Crohn’s disease
Inflammation, swelling, intestinal ulceration
IBD symptoms
Stomach pain
Weight loss
Diarrhoea (mucus/blood)
Tiredness
Join pain, Inflamed eyes, rashes
Ulcerative colitis
Affects large bowel
Inflammation on inner lining
Crohn’s disease
Affects any area of GI system
Inflammation in all tissues
IBD diagnosis
Blood test: anaemia, vitamin deficiencies, inflammatory markers
X-ray examination
CT + MRI scan
Sigmoidoscopy and colonoscopy
CD: enema, endoscopy
IBD causes
Genetic link
Autoimmune disease
IBD prevalence
Late teens/early 20s
White ethnic groups
Women > men
IBS Treatment
Inflammation
-Steroids
-Aminosalicylates
-Cytokine modulators
Autoimmune response
-Immunosuppressant drugs
Corticosteroids
Orally/rectally
Hydrocortisone
Beclomethasone
Budenoside
Prednisolone
Corticosteroids cautions
Congestive heart failure
Hypothyroidism
Osteoporosis
Corticosteroids side effects
Insomnia
Dyspepsia
Cushing’s syndrome
Impaired hearing
Adrenal suppression (long term use)
Corticosteroids interactions
Sntagonise diuretic effect
Budesonide - Grapefruit juice
Aminosalicylates
Orally/rectally
Balsalazide
Mesalazine
Olsalazine
Sulfasalazine
Aminosalicylates side effects
Blood disorders
Bruising
Sore throat]
Fever
Check renal function
Sulfasalazine
Orange urine and contact lenses
Decreases concentration of digoxin
Decreases absorption of folates
Cytokine modulators
Subcutaneous
Infliximab
Adalimumab
Golimumab
Vedolizumab
Cytokine modulators MOA
Stop expansion of activated T cells - interacting with calcineurin cascade
Immunosuppressants
Orally/injections
Azathioprine
Ciclosporin
Mercaptopurine
Methotrexate
Immunosuppressants caurions
Anticancer drugs with blood toxcity and liver toxicity
Methotrexate
Weekly dose 2.5mg tablets
Follow up with folic acid
Methotrexate side effects
Sore throat
Bleeding
Bruising
Mouth ulcers
Methotrexate cautions
FBC, renal and liver monitoring
Treatment use
Mild in rectum - local steroid/aminosalicylate
Diffuse/unresponsive IBD - orally
Severe - parental administration, steroid, immunosuppressant and antibody therapy
Non-drug treatment
Smoking cessation
Attention to diet
Stoma operations
Resection operations