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Maddy - GI II Exam I - some pharm > Pharm - IBD > Flashcards

Pharm - IBD Flashcards

1
Q

list the 4 5-ASA drugs used for ulcerative colitis

A
  • sulfasalazine
  • mesalamine
  • olsalazine
  • balsalazide
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2
Q

list the janus kinase (JAK) inhibitors used for ulcerative colitis

A

tofacitinib

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3
Q

list the TNF-a inhibitors used for ulcerative colitis

A
  • adalimumab
  • golimumab
  • infliximab
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4
Q

list the alpha-4 integrin inhibitors used for ulcerative colitis

A

vedolizumab

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5
Q

list the IL-12/23 inhibitors used for crohn disease

A

ustekinumab

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6
Q

list the TNF-a inhibitors used for crohn disease

A
  • adalimumab
  • certolizumab
  • infliximab
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7
Q

list the alpha-4 integrin inhibitors used for crohn disease

A
  • natalizumab

- vedolizumab

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8
Q

what TNF-a inhibitors are used for both UC and CD

A

adalimumab and infliximab

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9
Q

what alpha-4 integrin inhibitors are used for both UC and CD

A

vedolizumab

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10
Q

MOA 5-ASA agents

A

inhibition of prostaglandin and leukotriene production via arachidonic acid pathway
+
reduction in PMN and macrophage chemotaxis

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11
Q

when to use rectal suppositories, rectal enemas, and oral 5-ASA agents

A

rectal suppositories: to reach upper rectum

rectal enemas: to reach the splenic flexure

oral: to reach the entire GI tract

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12
Q

side effects 5-ASA agents

A
  • CNS: dizziness, HA, fatigue

- GI: anorexia, abd pain, N/V/D

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13
Q

sulfasalazine is contraindicated in what patients

A

those with sulfa allergies

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14
Q

all 5-ASA compounds are contraindicated in what patients

A

ASA-allergic patients

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15
Q

indications for 5-ASA agents

A

active AND maintenance of mild to moderate UC

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16
Q

indications for olsalazine (a 5-ASA agent)

A

ONLY for maintenance of remission UC (not active dz)

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17
Q

indications for balsalazide (a 5-ASA agent)

A

ONLY for active dz UC (and only approved in males)

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18
Q

MOA TNF-a inhibitors

A

blocks TNF-a which blocks leukocyte migration to site of inflammation

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19
Q

list the methods of administration of the TNF-a inhibitors for UC and crohn’s

A
  • adalimumab: SQ injection
  • golimumab: SQ injection
  • infliximab: IV injection
  • certolizumab: SQ injection
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20
Q

which TNF-a agent is used ONLY for CD

A

certolizumab

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21
Q

which TNF-a agent is used ONLY for UC

A

golimumab

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22
Q

side effects TNF-a inhibitors

A
  • infections
  • liver toxicity
  • HA/arthralgias/fatigue
  • dermatologic related
  • malignancies
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23
Q

what MUST you do before giving TNF-a inhibitors

A

TB testing

24
Q

indications for TNF-a inhibitors

A

active dz AND management of MODERATE TO SEVERE UC and CD (depending on drug)

25
Q

indications for adalimumab

A

active and management of moderate to severe UC and CD

26
Q

indications for infliximab

A

active and management of moderate to severe UC and CD

27
Q

indications for golimumab

A

active and management of moderate to severe UC only

28
Q

Indications for certolizumab

A

active and management of moderate to severe CD only

29
Q

when are TNF-a inhibitors used

A

after inadequate response to conventional or immunosuppressant therapy

30
Q

what is the maintenance dose and administration method for adalimumab

A

SQ injection every 2 weeks

31
Q

what is the maintenance dose and administration method for infliximab

A

IV infusion every 8 weeks

32
Q

what is the maintenance dose and administration method for golimumab

A

SQ injection every 4 weeks

33
Q

what is the maintenance dose and administration method for certolizumab

A

SQ injection every 4 weeks

34
Q

MOA alpha-4 integrin inhibitors

A

limits integrin’s cell adhesion and transepithelial migration of leukocytes to site of inflammation

35
Q

route of administration for natalizumab

A

IV injection

36
Q

route of administration for vedolizumab

A

IV injection

37
Q

compare which integrins are inhibited by natalizumab and vedolizumab

A

natalizumab: alpha 4 B1 and alpha 4 B7
vedolizumab: just alpha 4 B7

38
Q

side effects alpha-4 integrin inhibitors

A

infections

  • progressive multifocal leukoencephalopathy
  • infusion related reactions
  • anti-medication antibodies
  • increased risk of malignancy
39
Q

indications of natalizumab

A

active dz and maintenance of moderate to severe CD

40
Q

indications for vedolizumab

A

active dz and maintenance of moderate to severe CD and UC

41
Q

when are alpha-4 integrin inhibitors used

A

after inadequate response to conventional therapy of TNF-a therapy

42
Q

what is the maintenance dose and administration method for natalizumab

A

IV infusion every 4 weeks

43
Q

what is the maintenance dose and administration method for vedolizumab

A

IV infusion every 8 weeks

44
Q

MOA IL-12/23 inhibitors

A

bind to P40 subunit of IL-12 and IL-23, blocking activation and differentiation of naive T cells and activation of NK cells

45
Q

side effects of ustekinumab (IL-12/23 inhibitor)

A
  • infections
  • infusion related reaction
  • HA/arthralgia/fatigue
  • increase risk of malignancy
46
Q

what must you do before giving IL-12/23 inhibitors

A

TB testing

47
Q

indications for ustekinumab (IL-12/23 inhibitor)

A

active dz and maintenance of moderate to severe CD

48
Q

when should you prescribe ustekinumab

A

when patients are intolerant or have inadequate response to conventional, immune modulators, steroids, or TNF-a therapy

49
Q

what is the maintenance dose and administration method for ustekinumab

A

SQ injection every 8 weeks

50
Q

MOA janus kinase (JAK) inhibitors

A

bind to and inhibit free-floating and bound JAK-1 and JAK-3 which inhibits gene transcription and more cytokine release

51
Q

side effects tofacitinib (a JAK inhibitor)

A
  • lymphopenia/lymphocytosis
  • neutropenia/anemia
  • fatigue
  • increases in LDL and HDL
  • increase risk of malignancy
52
Q

indications for tofacitinib (a JAK inhibitor)

A

active dz and maintenance of moderate to severe UC

53
Q

what is the maintenance dose and administration method for tofacitinib

A

PO BID

54
Q

what drugs can patients not take while taking tofacitinib

A

biologig therapies or potent immunosuppressants

55
Q

describe the use of steroids in treating IBD

A

used at the lowest dose for the shortest duration possible for acute and/or severe UC or CD

NOT for maintenance of remission unless ABOLUTELY required

Maddy - GI II Exam I - some pharm (23 decks)

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