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A - NAPLEX > Chapter 74: Inflammatory Bowel Disease > Flashcards

Chapter 74: Inflammatory Bowel Disease Flashcards

1
Q

Classic symptom of IBD

A

bloody diarrhea

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2
Q

Which class of drugs can cause IBD flares

A

NSAIDs

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3
Q

What is the difference between IBS and IBD

A

IBS does not cause inflammation

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4
Q

Ulcerative colitis is characterized by mucosal inflammation confined to the

A

rectum and colon with superficial ulcerations

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5
Q

When UC is limited to the descending colon and rectum, it is called ___ and can be treated with ____

A

distal disease

topical (rectal) treatment

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6
Q

Inflammation limited to the rectum is called

A

proctitis

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7
Q

Fistuals/strictures are common in crohn’s disease or ulcerative colitis

A

CD

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8
Q

Where is Crohn’s Disease located

A

Entire GI tract

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9
Q

Crohn’s Disease depth is

A

Transmural

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10
Q

CD pattern vs UC pattern

A

CD is non-continuous

UC is continuous

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11
Q

What is commonly used to treat acute exacerbations in both UC and CD

A

short courses of oral or IV steroids

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12
Q

What is used for maintenance therapy in UC (distal or mild extensive disease)

A

aminosalicylates

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13
Q

What is preferred for mild CD that is limited to the ileum and proximal colon

A

Budesonide for less than or = 3 months

After this course, d/c treatment or change to thiopurine or MTX

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14
Q

What can be used for moderate-severe CD for maintenance of remission

A

Anti-TNF agents (Humira, Remicade, Cimzia)
Thiopurine
MTX
Stelara

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15
Q

What can be used for refractory treatment or steroid dependent CD

A

Vedolizumab or natalizumab

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16
Q

What can be used for mild UC for maintenance of remission

A

Mesalamine (5-ASA) rectal and/or oral preferred

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17
Q

What can be used for moderate-severe UC for maintenance of remission

A 
Anti-TNF agents (Humira, Remicade, Simponi)
Thiopurine
Cyclosporine
Stelara
Xeljanz
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18
Q

What can be used for refractory treatment or steroid dependent UC

A

Vedolizumab

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19
Q

Budesonide brand name

A 
Entocort EC (for CD only)
Uceris (for UC only)
20
Q

If steroids are used long than ___ weeks, they must be tapered

A

2 weeks

21
Q

If long-term use of steroids is required, must assess

A

bone density

22
Q

Which drug can be used for both induction and maintenance of UC and CD

A

Budesonide

23
Q

Rectal steroids (hydrocortisone and budesonide rectal foam) are indicated for __ only

A

UC

24
Q

When using budesonide, must avoid strong and moderate ____ of which CYP enzyme, including ____

A

inhibitors
3A4
grapefruit juice and grapefruit products

25
Q

Which formulations does mesalamine come in

A

oral and rectal

26
Q

Induction with mesalamine for UC oral therapy is used for ___ weeks and rectal therapy for ___ weeks

A

6-8 oral

3-6 rectal

27
Q

Mesalamine rectal suppository should be retained in the rectum for at least ___ hours

A

1-3

28
Q

Mesalamine enema should be retained in the rectum for how long

A

Overnight

29
Q

Mesalamine CI

A

hypersensitivity to salicylates or aminosalicylates

30
Q

For distal disease/proctitis in UC, which formulation of mesalamine is more effective

A

Rectal

31
Q

Mesalamine ER tablet (Asacol) and ER capsule (Delzicol) can

A

Leave a ghost tablet in the stool

32
Q

Sulfasalazine CI

A

salicylate and sulfa allergy

33
Q

Balsalazide can cause

A

staining of the teeth/tongue

34
Q

Patients with which genetic deficiency are at increased risk of myelosuppression when using azathioprine

A

TPMT

35
Q

Methotrexate can be used for induction & maintenance of remission in mod-severe

A

CD (in pts who cannot tolerate azathioprine)

36
Q

How is MTX dosed in CD

A

once weekly by IM or SC route

37
Q

Which immunosuppressive drug is recommended for severe UC

A

Cyclosporine

38
Q

Natalizumab is only approved for

A

CD

39
Q

How often is natalizumab given

A

every 4 weeks

40
Q

Natalizumab should be d/c if no response by ___ weeks

A

12

41
Q

Vedolizumab is approved for

A

UC and CD

42
Q

Vedolizumab should be d/c if no response by ___ weeks

A

14

43
Q

Natalizumab boxed warning

A

PML

44
Q

Natalizumab is only available through

A

REMS TOUCH program

45
Q

Natalizumab brand name

A

Tysarbi

46
Q

Vedolizumab brand name

A

Entyvio

A - NAPLEX (83 decks)

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