Treatments for IBD Flashcards
Sulfasalazine, Mesalamine, Olsalazine, and Balsalazide make up what drug class?
Aminosalicylate (5-ASA) drugs
Sulfasalazine, Olsalazine, and Balsalazide are all converted to?
Mesalamine
What is the MOA of the 5-ASA agents?
Inhibition of prostaglandin and leukotriene production via COX (cyclooxygenase) and LIPOX (lipoxygenase) pathways
5-ASA agents result in the reduction of chemotaxis of?
PMN and macrophage
All 5-ASA compounds are contraindicated in?
When is sulfasalazine additionally contraindicated?
1) ASA allergic patients
2) Sulfa allergic patients
Which 5-ASA agents is used only for maintenance of remission?
Which is used only for active UC?
1) Olsalazine
2) Balsalazide
What are the 5-ASA agents?
1) Sulfasalazine
2) Mesalamine
3) Olsalazine
4) Balsalazide
Adalimumab, Golimumab, Certolizumab and Infliximab make up what class of drugs?
TNF-α inhibitors
TNF-α binds to TNF receptors and mediates upregulation of what surface adhesion molecules for leukocyte adhesion?
1) VCAM-1
2) E-selectin
3) MAdCAM-1
What is the side effect for TNF-α inhibitors?
What should be done pre-therapy?
1) Increase risk of infection
2) TB testing
Which TNF-α inhibitors is used for moderate to severe UC and CD?
Adalimumab
Which TNF-α inhibitors is used for moderate to severe CD and severe UC?
Infliximab
Which TNF-α inhibitors is used for UC only?
Golimumab
Which TNF-α inhibitors is used for CD only?
Certolizumab
When are all TNF-α inhibitors and α-4 Integrin inhibitors used?
After inadequate response to 5-ASA
What is the dosing for Adalimumab?
What is the dosing for Infliximab?
What is the dosing for Golimumab?
What is the dosing for Certolizumab?
1) SQ every 2 weeks
2) IV every 8 weeks
3) SQ every 4 weeks
4) SQ every 4 weeks
What are the TNF-α inhibitors?
1) Adalimumab
2) Golimumab
3) Infliximab
Vedolizumab and Natalizumab makes up what class of drug?
α-4 Integrin Inhibitors
Which α-4 Integrin inhibitors targets α4β7 so that is can’t go to its receptor MAdCAM-1?
Which targets α4β1 and α4β7 so that it can’t go to its receptor VCAM-1 and MAdCAM-1 respectively?
1) Vedolizumab
2) Natalizumab
What side effects are seen with α-4 Integrin inhibitors?
1) Increased risk of infections
2) PML
What is the indication for natalizumab?
What is the indication for vedolizumab?
1) CD
2) CD and UC
What is the dosing for natalizumab?
What is the dosing for vedolizumab?
1) IV every 4 weeks
2) IV every 8 weeks
What are the α-4 Integrin Inhibitors?
1) Vedolizumab
2) Natalizumab
Ustekinumab makes up what class of drugs?
IL-12/23 Inhibitors
What is the mechanism for IL-12/23 inhibitors?
Bind to P40-subunit of IL-12 & IL-23 blocking activation of naïve T cells and NK cells
What is the side effect for Ustekinumab?
What should be done pre-therapy?
1) Increase risk of infection
2) TB testing
What is IL-12/23 inhibitors indicated for?
UC and CD
What is the dosing for IL-12/23 inhibitors?
SQ every 8 weeks
Tofacitinib makes up what class of drugs?
Janus Kinase (JAK) Inhibitors
Tofacitinib makes up what class of drugs?
Janus Kinase (JAK) Inhibitors
What is the MOA of the JAK inhibitor?
Bind to and inhibit free-floating and bound JAK-1 and JAK-3
What is Tofacitinib indicated for?
UC
What is the JAK inhibitor?
Tofacitinib
What are the agents for ulcerative colitis?
1) 5-ASA
2) Janus Kinase (JAK) Inhibitors
3) IL-12/23 Inhibitors
4) TNF-α Inhibitors
5) α-4 Integrin Inhibitors
What are the agents for crohn’s disease?
1) IL-12/23 Inhibitors
2) TNF-α Inhibitors
3) α-4 Integrin Inhibitors
