Treatment of IBD

Question 1

Mechanism of 5-ASA in IBD

Answer 1

Inhibit synthesis of prostaglandins and inflammatory leukotrienes and cytokines
Inhibits activity of NFkB

Question 3

First line agents for mild to moderate UC, used to induce and maintain remission

Answer 3

5-ASA compounds

Question 4

First line therapy for mild to moderate Crohn’s involving the colon and/or distal ileum

Answer 4

5-ASA compounds

Question 5

Generic name for 5-ASA used for IBD

Answer 5

Mesalmine

Question 6

Compounds containing 5-ASA

Answer 6

Sulfasalazine
Olsalazine
Balsalazine

Question 7

Side effect associated with high dose 5-ASA compound

Answer 7

Renal tubular damage

Question 8

Drug used in pts with moderate to severe IBD, to induce treatment and treat flares

Answer 8

Glucocorticoids

Question 9

Purine antimetabolites used to treat IBD

Answer 9

Azathioprine
6-mercaptopurine

Question 10

Drug class used to induce and maintain remission of IBD in pts who depend on long-term glucocorticoid therapy

Answer 10

Purine antimetabolites

Question 11

Adverse effects of purine antimetabolites

Answer 11

Bone marrow suppression
Hepatic toxicity
Lymphoma risk with long-term use

Question 12

Specific lab value to check before initiating therapy with purine antimetabolites and why

Answer 12

Thiopurine methyltransferase (TPMT)

Low TPMT associated with increased leukopenia risk

Question 13

DHFR inhibitor used to induce and maintain remission in Crohn’s

Answer 13

Methotrexate

Question 14

Adverse effects of methotrexate

Answer 14

Bone marrow suppression
Megaloblastic anemia
Alopecia
Mucositis

Question 15

Anti-TNF drugs used in IBD

Answer 15

Infliximab
Adalimumab
Golimumab
Certolizumab

Question 16

Drug class used for the acute and chronic treatment of moderate to severe IBD and in those with poor response to first line treatments

Answer 16

Anti-TNFs

Question 17

Anti-integrins used to treat IBD

Answer 17

Natalizumab
Vedolizumab

Question 18

Second line treatment for moderate to severe IBC, in those who cannot use anti-TNFs

Answer 18

Anti-integrins

Question 19

Specific side effect of Natalizumab

Answer 19

Reactivation of JCV to PML in CNS

Question 20

Used for severe IBS with diarrhea

Answer 20

Alosetron

Question 21

5-HT3 antagonist used for IBS

Answer 21

Alosetron

Question 22

Drugs used for IBS with constipation

Answer 22

Lubiprostone
Linaclotide

Question 23

Chloride channel activator used for IBS

Answer 23

Lubiprostone

Question 24

Activator of guanylyl cyclase C used for IBS

Answer 24

Linaclotide