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Gastrointestinal Week 5 2016/17 > 7: IBD therapy > Flashcards

Flashcards in 7: IBD therapy Deck (36)
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1

Which habit is altered in patients with IBD?

Bowel habit

2

What is the main aim of IBD therapy?

Control inflammation

Heal mucosa

3

What are the general therapy options for IBD?

Lifestyle advice

Drugs

Surgery

4

Which lifestyle factor aggravates Crohn's disease?

Smoking

5

Diet influences the gut ___ and therefore the symptoms of IBD patients.

microbiome

6

Quitting smoking reduces the recurrence of which inflammatory bowel disease?

Crohn's disease

7

Drug therapy for IBD tends to have an anti____ effect.

anti-inflammatory

8

Which class of drug was used exclusively for UC in the past?

5-ASAs (mesalazine)

9

Which classes of drugs are used in IBD?

Steroids

Immunosuppressants

Anti-TNF therapy

10

5-ASAs are used in ___ ___ and reduce the risk of ___ ___.

ulcerative colitis

colorectal cancer

11

What are the side effects of 5-ASAs e.g mesalazine?

Diarrhoea

Nephritis (check renal function regularly)

12

How can 5-ASAs be administered?

Oral

Suppositories

Enemas

13

Higher doses of 5-ASAs tend to produce (greater / smaller) responses in UC patients.

greater

14

5-ASAs are (oral/rectal/topical) therapies.

TOPICAL

route of admin may be oral / enema but the drug coats the wall of the GI tract so it's topical

15

What is the first line therapy in Crohn's disease (and after 5-ASAs in UC)?

Corticosteroids

16

Corticosteroids have a systemic ___-___ effect.

anti-inflammatory

17

What are some examples of oral steroids used in IBD?

Prednisolone

Budesonide

18

Why are corticosteroids only used short-term in the treatment of IBD?

Steroid dependence / resistance

side effects: osteoporosis, see slides

19

What are some GI side effects of steroids?

Increased appetite

Ulcers

20

What are steroid-sparing agents?

Medications used instead of corticosteroids in UC:

Immunosuppressors

used after steroids (to avoid steroid dependence)

21

What drugs are used as a maintenance therapy in Crohn's disease?

Immunosuppressors

22

Name some examples of immunosuppressors used in IBD therapy.

Azathioprine

Mercaptopurine

(Methotrexate)

23

Which tests are done on someone who is taking azathioprine?

FBCs (leukopaenia)

LFTs (hepatitis)

24

Azathioprine has a (fast / slow) onset of action.

What would be prescribed in the mean time?

slow

Steroids

25

What are some possible side effects of azathioprine therapy?

Pancreatitis

Leucopaenia

Hepatitis

Skin cancer

26

Which cells secrete TNFalpha?

Macrophages

Dendritic cells

during antigen presentation.

27

What is the function of TNFalpha?

Pro-inflammatory cytokine

drives recruitment of inflammatory immune cells

28

Which protein, involved in white cell adhesion in acute inflammation, is blocked by some IBD drugs?

Integrins

29

Which drugs are used to inhibit the action of TNFalpha in IBD?

Monoclonal antibodies

e.g infliximab, adalimumab

30

What respiratory disease may be reactivated by the action of anti TNFalpha drugs?

TB