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Gastrointestinal > IBD Therapy > Flashcards

IBD Therapy Flashcards

1
Q

management of IBD

A

lifestyle modifications
drugs
surgery

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2
Q

lifestyle mofnicaitons of IBD

A

stop smoking - Crohn’s

diet - influences symptoms (not pathogenesis)

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3
Q

drug treatment of ulcerative colitis

A

5ASA
steroids
immunosuppressants
anti-TNF therapy

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4
Q

5ASA for ulcerative colitis

A

mesalazine - pentasa or asacol

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5
Q

steroids for ulcerative colitis

A

mild/moderate - prednisolone

severe - hydrocortisone

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6
Q

drug treatment for Crohn’s

A

steroids
immunosuppressants
anti-TNF therapy
antibiotics (for peri-anal disease)

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7
Q

steroids for Crohn’s

A

mild - prednisolone or budesonide

moderate/severe - hydrocortisone

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8
Q

add on therapies for UC

A

Sulfasalazine - anti-inflammatory

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9
Q

anti-TNF therapy

A

infliximab - IV, chimeric

adalimumab - S/C injection, humanised

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10
Q

5ASA mechanism of action

A

topical effect
anti-inflammatory properties
reduces risk of colon cancer

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11
Q

side effects of 5ASA

A

diarrhoea

idiosyncratic nephritis

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12
Q

asacol

A

oral

pH dependent release - Ileum and colon only

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13
Q

pentasa

A

oral

delayed release - used in small and large bowel

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14
Q

salazopyrin

balsalazide

A

5ASA;
oral
colon only

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15
Q

musculoskeletal steroid side effects

A

avascular necrosis

osteoporosis

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16
Q

cutaneous steroid side effects

A

acne

thinning of skin

17
Q

metabolic side effects of steroid

A

weight gain
diabetes
hypertension

18
Q

immunosuppressants for Crohn’s

A

azathioprine/mercaptopurine

methotrexate - not safe in pregnancy

19
Q

side effects of azathioprine

A

pancreatitis
leucopaenia
hepatitis
small risk of lymphoma, skin cancer

20
Q

azathioprine

A

slow onset of action
TPMT - contributes to toxicity
avoid co-prescription of allopurinol - CO inhibitor
requires regular blood monitoring

21
Q

azathioprine metabolism

A

PP

22
Q

inflammatory pathways targeted in IBD

A

TNFalpha
MadCAM
T cell alpah4-beta7

23
Q

anti TNF mechanism of action

A

promotes apoptosis of activated T lymphocytes

rapid onset of action

24
Q

side effects of anti TNF

A

infusion reactions
infection
cancer - lymphoma, solid tumours

25
Q

biosimilar anti-TNFs

A

inflectra

remsima

26
Q

emergency surgery in IBD

A

failure to respond to medical therapy
small bowel obstruction
abscess
fistulae

27
Q

elective surgery in IBD

A

failure to respond to medical therapy

dyspepsia of colon mucosa

28
Q

surgery for Crohn’s

A

not curative

can result in short gut syndrome - requiring type 3 intestinal failure

29
Q

surgery for ulcerative colitis

A

curative

Gastrointestinal (71 decks)

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