Ulcerative Colitis Flashcards
Diagnosis for ulcerative colitis (6)
Low HB
Raised CRP, WBC and ESR
Significantly raised faecal calprotein
Can be PANCA +ve
Continuous uniformity inflamed mucosa
Polyps and ulcers
First line treatment for inducing treatment in mild to severe ulcerative colitis
Topical aminosalicylate
Second line treatment for inducing treatment in mild to severe ulcerative colitis
Add on oral aminosalicylate
Third line treatment for inducing treatment in mild to severe ulcerative colitis
Topical aminosalicylate and oral aminosalicylate already taken. So add LIMITED COURSE OF CORTICOSTEROIDS
4th line treatment for ulcerative colitis
Biologics (infliximab) or JAK inhibitor (Tofacitinib)
First line treatment from acute severe ulcerative colitis
IV hydrocortisone
2nd line for acute severe ulcerative colitis
IV hydrocortisone and IV Ciclosporin
Third line treatment for acute severe ulcerative colitis
Infliximab
First line for maintenance of ulcerative colitis
Topical or oral aminosalicylates
2nd line treatment for maintenance of ulcerative colitis
Azathioprine or Mercaptopurine
What are the prescribing directions for aminosalcylates (mesalazine, Sulfasalazine)
Must be prescribed by brand
What blood tests need to be done when a patients on aminosalicylates (mesalazine, Sulfasalazine)
Renal tests
Full blood count
What are the red flag/monitoring requirements for aminosalicylates (mesalazine/ Sulfasalazine)
Agranulocytosis- bruising, sore throat, fever
Which type of medication requires there to be adequate resuscitation facilities when administered
Biologics (Infliximab)
What is required before giving patients biologics
Screening for TB
Patients vaccines must be up to date
Which medication means you cannot drive
Biologics
What medication requires you to be given an alert card
Biologics
What needs to be monitored for corticosteroids
Blood pressure
Weight
HBA1C
Cholesterol
Potassium
Eye exam
Osteoporosis
Adrenal suppression
What needs to be given to patients on corticosteroids
Steroid treatment card
What needs to be done before prescribing/ taking Azathioprine/ Mercaptopurine
Screening of TPMT
If TPMT levels are low, what does this indicate
Myelosuppression
What are the 4 side effects associated with Azathioprine/ Mercaptopurine
Hypersensitivity
Nausea
Increased infection risk
Immunosuppression
What needs to be monitored in as patient on Azathioprine/mercaptopurine
Toxicity
Full blood count
What are the red flag signs associated with Azathioprine/Mercaptopurine
Unexplained bruising, bleeding, sore throat and infection
Indicates bone marrow suppression
