Pharm - Tx for IBD Flashcards
What are the 4 familial agents used to treat UC?
- 5-ASA
- JAK inhibitors
- TNF-a inhibitors
- a4 Integrin inhibitors
sulfasalazine
mesalamine
olsalazine
balsalazide
5-ASA’s
tofacitinib
JAK inhibitor
adalimumab
golimumab
infliximab
TNF-a inhibitors (for UC)
vedolizumab
a4 integrin inhibitor
what are the 3 familial agents used to treat Crohn disease?
- IL-12/23 inhibitors
- TNF-a inhibitors
- a4 integrin inhibitors
ustekinumab
IL-12/23 inhibitor
adalimumad
certolizumab
infliximab
TNF-a inhibitors (for CD)
natalizumab
vedolizumab
a4 integrin inhibitors
what is the MOA of 5-ASA agents?
inhibit prostaglandin and leukotriene production via arachidonic acid pathway
- may also inhibit the activation of NF-kb, regulating transcription of pro-inflammatory proteins
what drug is sulfapyridine + 5-ASA?
sulfasalazine
- sulfa is carrier molecule, 5-ASA provides antimicrobial property
- watch for sulfa allergy!
which drug is a single 5-ASA?
mesalamine
which drug is 2 molecules of 5-ASA?
olsalazine
which drug is an inert carrier + 5-ASA? why is this drug important?
balsalazide
- don’t have to worry about sulfa allergy with an inert carrier!
which form of 5-ASA may be released in the distal/terminal ileum, colon, or throughout GI tract?
oral form
which form of 5-ASA may reach the splenic flexure and does not concentrate in the rectum?
rectal enemas
what form of 5-ASA can reach the upper rectum (15-20cm beyond the anal verge)?
rectal suppositories
what are the side effects of 5-ASA agents?
- dizziness, headache, fatigue
- epigastric distress (anorexia, abd pain, NVD)
what drug drug is contraindicated in sulfonamide-allergic patients?
sulfasalazine
what are the indications for 5-ASA agents?
mild-moderate UC
what are the exceptions for 5-ASA indications?
- olsalazine is ONLY used for maintenance of remission
- balsalazine is ONLY used for active disease (not remission)