Ulcerative Colitis & Cronh's D Flashcards
- Ulcerative colitis (UC): is an inflammatory disease of the large intestine. Ulcers form in the inner lining, or mucosa of the colon or rectum often resulting in diarrhea, blood, and pus
- Crohn’s Disease (CD): is an inflammatory that extended into the deeper layer of the intestinal wall. It’s most often in the ileum and the cecum
- Suggested tx algorithm
- Start with mesalamine => corticosteroid => immune suppressant
- Allergy to mesalamine, start with corticosteroid
- If allergy to sulfa, do not use sulfasalazine
Lialda
- Administration instruction
- Special about this tab
- —- for all 5-ASA—-
- C/I
- SEs
- Urine color:
Mesalamine (5-ASA) DR
- Dose: 2-4 tabs QD w/ FOOD. Do not crush or chew.
- Tab is coated with a pH dependent polymer film, which breaks down at or above pH 6.8
- Similar to ASA. Avoid in salicylate sensitivity
- SEs: HA, abdominal pain, fever, rash
- Discolor of urine yellow-brown
Asacol HD
- Dose/frequency
Mesalamine High Dose
- DR: 800 - 1600mg TID. Swallow whole tab
Delzicol
- Direction to take
Mesalamine DR
- Take on EMPTY stomach: 1H b/4 meal or 2H after
Pentasa
- Dose
Mesalamine CR
- Dose: 1g QID
Canasa
- Dose
Mesalamine rectal suppository
- Dose: 1000mg QHS. Retain for 1-3hrs to achieve max benefit.
Rowasa
- Dose
- Counseling point regarding suppository
Mesalamine rectal suspension enema
- Take 4g/60mL QHS. Retain over night ~ 8H
Counseling:
- Pt must use promptly once foil wrap is removed. If contents darken (dark brown), discard
Colazal
- Frequency
- Prodrug
- CI
Balsalazide
- Giazo: UC in males (three 1.1g tab BID x 8wks
- Balsalazide cleaved in the colon to produce mesalamine.
- Frequency: TID
- CI: salicylate allergy
Azulfidine
- C/I
- SE
- Monitor
- Body fluid
- Indication
Sulfasalazine (DMARD)
- C/I: sulfa and aspirin allergy
- SEs: HA, skin rash, hepatitis, kidney inflammation, infertility, impaired folate absorption, BMS
- Monitor: LTF, CBC, CNS
- Body fluid: turn orange yellow
- I: UC, RA
Uceris
- Indication
- Frequency
Budesonide
- Indication: UC
- Frequency: QD AM
Medrol
- Dose
Methylprednisolone
- Dose: 35-40mg/day PO QAM
Cortef
- Dose
Hydrocortisone
- 200-300 mg/d PO QAM
Cortenema
Hydrocortisone enema
Cortifoam
Hydrocortisone acetate rectal foam
Sandimmune
- Indication
Cyclosporine
- Indication: UC when refractory to corticosteroid (off-label), psoriasis, rheumatoid arthritis, solid organ transplant, GVHD,
Remicade
- Class
- Frequency
- Indication
Infliximab
- Class: TNF-blocker
- Frequency: Start at 0, 2, 6 week then Q8W
Indication: - UC that refractory to corticosteroid
- Crohn disease
- Ankylosing spondylitis
- Psoriatic arthritis
- Rheumatoid arthritis
Humira
- Class
- Frequency
- Indication
Adalimumab SQ
- Class: TNF-blocer
- Frequency: Q2W
Indication:
- Ankylosing spondylitis
- Crohn Disease/UC
- Juvenile idiopathic arthritis
- Plaque psoriasis
- Psoriasis arthritis
Cimzia
- Class
- Frequency
- Indication
Certrolizumab SQ
- Class: TNF-blocer
- Frequency: Q4W
Indication: - Ankylosing spondylitis
- Crohn Disease
- UC
- Psoriatic arthritis
- Rheumatoid arthritis
Simponi
- Class
- Indication
Golimumab
- Class: TNF-blocer
Indication:
- UC
- Ankylosing spondylitis
- Psoriatic arthritis
- Rheumatoid arthritis
Imuran
- Indication
Azathioprine
Indication
- Renal transplant
- Rheumatoid arthritis
- UC (off label)
Purinethol
Purixan
- Indication
6-Mercaptopurine
Indication
- UC (off label)
- Crohn’s Disease
- ALL/APL (P = promyelocytic)
Entocort
- Indication
Budesonide
- Indication: Crohn’s Disease
Dipentum
Olsalazine
Apriso
- Frequency
Mesalamine
- PO QD AM
Giazo
- Indication
- Frequency
- C/I
Balsalazine
- I: UC in man
- Frequency: BID
- C/I aspirin allergy
Solu-Medrol
- Form
Methyprednisolone
- IV 40mg QD
Entyvio
- Indication
- Form
Vedolizumab
- I: Crohn’s D and UC
- Form: IV
