Week 2: GI Tract - Pharmacology for IBD Flashcards

1
Q

What 4 drug classes are used for inflammatory bowel disease? (4)

A
  • 5-aminosalicylates
  • Glucocorticoids
  • Immunomodulatora
  • Immunosuppressants
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2
Q

Which medication is an example of a 5-aminosalicylate?

A

sulfasalazine

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3
Q

What are the indications for sulfasalazine? (2)

A
  • Mild to moderate IBD
  • maintain remission after symptoms have improved
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4
Q

What is the MOA of sulfasalazine?

A
  • Action on prostaglandin synthesis and suppression of migration of inflammatory cells into the affected region
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5
Q

What are nursing considerations for sulfasalazine?

A
  • Monitor CBC periodically because it can cause hematological disorders
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6
Q

What are adverse effects of sulfasalazine?

A
  • nausea
  • fever
  • rash
  • arthralgia (sore joints)
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7
Q

Which medication is an example of a glucocorticoid for IBD?

A

budeosonide

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8
Q

What are the indications for budesonide?

A
  1. Mild to moderate ulcerative colitis
    - works locally within ileum and ascending colon
    - Use is to induce remission, not for long term maintenance
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9
Q

What is the MOA of budesonide?

A

Anti-inflammatory action

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10
Q

What are the routes of admin for budesonide? (2)

A
  • IV
  • PO (enteric coated capsule)
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11
Q

What are nursing considerations for budesonide? (4)

A

Prolonged use of glucocorticoids can cause severe adverse effects like:
- adrenal suppression
- Osteoporosis
- Increased risk for infection
- Cushing’s syndrome

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12
Q

Which medication for PUD is an example of an immunomodulator?

A

Infliximab

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13
Q

What is the MOA of infliximab? (2)

A
  • Monoclonal antibodies
  • Designed to neutralize TNF, a key immuno-inflammatory modulator
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14
Q

What are the indications of infliximab? (2)

A
  • Moderate to severe ulcerative colitis and Crohn’s
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15
Q

What are the adverse effects of infliximab? (3, 9)

A
  1. Infections
    - TB and other opportunistic infections are most common
  2. Infusion reactions
    - fever
    - chills
    - pruritis
    - urticaria
    - cardiopulmonary reactions (chest pain, HTN, hypotension)
  3. Increased risk of lymphoma
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16
Q

What is the regimen for infliximab?

A
  • 6 week regimen followed by maintenance infusions every 8 weeks after

note that it is considered 2nd line for IBD because of pros vs cons

17
Q

Which medication for PUD is an example of an immunosuppressant?

A

cyclosporine

18
Q

What is the MOA of cyclosporine? (2)

A
  • calcineurin inhibitory and is a very strong immunosuppressant
  • faster acting and stronger than other immunosypressants
19
Q

How is cyclosporine administered? (3)

A
  • Long term therapy
  • Continuous IV infusion
  • Can also be administered orally in low doses to maintain remission
20
Q

What are adverse effects of cyclosporine?

A
  • Increased lymphoma risk. further increased when used with other immunosuppressants
21
Q

What are nursing considerations for cyclosporine? (3)

A

Potentially toxic compound
- can cause renal impairment (check urine output)
- neurotoxicity
- generalized suppression of the immune system = increased risk of infection

22
Q

What are indications for cyclosporine?

A
  • Severe disease that has not responded to other therapies, both UC and Crohns

usually taken by organ transplant pts to reduce inflammation