Therapeutics of IBD

Question 1

What is the management of CD?

Answer 1

INDUCING REMISSION:
mild to moderate- oral prednisolone

moderate to severe - IV hydrocortisone + biologics - infliximab, adalimumab

fistulating disease - antibiotics/drainage + biologics

MAINTENANCE:
mild - azathioprine/mercaptopurine + methotrexate

severe - azathioprine/mercaptopurine + methotrexate + biologics

fistulating - azathioprine/mercaptopurine + methotrexate + biologics

Question 2

What is the management of UC?

Answer 2

INDUCING REMISSION:
MILD - 5-ASA, topical steroids if proctitis or left sided disease or oral steroids - beclomethasone, prednisolone

MODERATE - oral steroids - prednisolone, 5-ASA tacrolimus if steroids don’t work well

SEVERE - IV hydrocortisone or IV ciclosporin - if don’t respond well to steroids, infliximab rescue therapy, may require surgery if severe acute colitis

MAINTENANCE:
mild - azathioprine/mercaptopurine

moderate - azathioprine/mercaptopurine

severe - azathioprine/mercaptopurine

Question 3

Why choose azathioprine over mercaptopurine and vice versa?

Question 4

Difference b/w prednisolone and budesonide?

Question 5

Aminosalicylates?

Question 6

Azathioprine?

Question 7

methotrexate?

Question 8

ciclosporin?

Question 9

infliximab?

Question 10

when is surgery licensed in CD and UC?
what are some complications of surgery?