IBD drugs Segars

Question 1

which ASA is used only for maintence therapy in UC

Answer 1

olsalazine

Question 2

which a-4 integrin inhibtor is administered less often

Answer 2

vedolizumab

Question 3

agents for UC categories

Answer 3

5-ASA (sala)
corticosteroids
TNF-a inhibtors (mab) (Golimumab)
a-4 integrin inhibitors (vedolizumab)

Question 4

side effects of eluxadoline

Answer 4

GI related
hepatic/pancreatic toxicity
CNS related

Question 5

alosetron indication

Answer 5

women with chronic, severe IBS-D not responsive to other conventional therapies

Question 6

a-4 integrin inhibitors mechanism of action

Answer 6

limits integrin associated cell adhesion

Question 7

loperamide MOA

Answer 7

for diarrhea
interferes with peristalsis by direct action on circular and longitudinal muscles of intestinal wall, slowing motility
-may also directly inhibit fluid and electrolyte secretion and or increase water absorption

Question 8

side effects of alosetron

Answer 8

constipation

ischemic colitis

Question 9

indications for a-4 integrin inhibitors

Answer 9

moderate to severe treatment resistant CD and UC and maintenance therapy to prevent relapse

Question 10

uses of interleukin IL-12/23 inhibitors

Answer 10

moderate to severe treatment resistant CD (active and maintenance)

Question 11

MOA for 5-ASAs

Answer 11

block COX and LIPOX which decreases PG and LT

Question 12

uses of 5-ASA agents indications

Answer 12

mild to moderate active UC and maintenance of remission of UC

Question 13

ustekinumab is what

MOA

Answer 13

interleukin IL-12/23 inhibitor
bind to specific subunit of IL-12/23 receptor located on surface of T cells and natural killer cells
-stops signal transduction and production of proinlfamm th1 and th17 cells

Question 14

lubiprostone

Answer 14

activates specific CIC-2 chloride channels in luminal cells of intestinal epitheliumv = chloride rich intestinal fluid secretion

• prostaglandin E-1 derivative
• lube up the intestine

Question 15

which of the 5-ASAs has 2 molecules of 5-ASA

Answer 15

olsalazine

Question 16

which of the 5-ASAs have side effects

Answer 16

sulfasalazine

Question 17

diphenoxylate
for what, moa
what is added to discourage abuse
side effects

Answer 17

diarrhea with IBS
works on GI SM cells, inhibts motility and slows excess GI propulsion

atropine added

SE: constipation, dizziness, drowsiness, urinary retetnion

Question 18

which 5-ASA is used only for treatment of active disease UC

Answer 18

balsalazide

Question 19

which TNF-a inhibitor is a FAb’

what are the rest

Answer 19

certolizumab is a Fab

rest are IgG monoclonal antibody

Question 20

alosetron

Answer 20

for IBS-D

blocks 5HT3 receptors

Question 21

side effect of interleukin IL-12/23 inhibitor

Answer 21

infections

-TB testing pre-therapy recommended

Question 22

lubiprostone SE

Answer 22

nausea, dyspepsia, dizziness

Question 23

uses of steroid agents

Answer 23

acute and or severe UC and CD uncontrolled by other conventional meds

Question 24

IBS drug class for abdominal pain

Answer 24

antimuscarinics

• hyoscyamine
• dicyclomine
• clidinium/chlorodiazepoxide

Question 25

agents for CD

Answer 25

IL-12/23 inhibitors (ustekinumab) corticosteroids TNF-a inhibitors (mab) (certolizumab) a-4 integrin inhibitors (natalizumab and vedolizumab)

Question 26

side effects of linaclotide

Answer 26

diarrhea, abd pain don't use under 17 yrs old

Question 27

linaclotide

Answer 27

for IBS-C moa: binds to guanylate cyclase C on luminal surface of intestinal epithelium (agonist) - stimulates secretion of chloride/bicarb into intestinal lumen via activation of CFTR which results in increased intestinal fluid and accelerated transit tide of fluid

Question 28

eluxadoline

Answer 28

agonist at opiod mu and kappa receptors in GI tract | antagonist at delta opooid receptors

Question 29

side effects of a-4 integrin inhibitors

Answer 29

infections - PML - 3 risk factors - treament over 2 yrs, prior immunosupp therapy, anti-jc virus antibodies

Question 30

side effects of TNF-a inhibitors

Answer 30

infections (especially adalimumab) | TB testing pre-therapy

Question 31

which a-4 integrin inhibitors are used for chrons

Answer 31

natalizumab and vedolizumab my chronnies are in NV

Question 32

dosing of TNF-a inhibitors, which one is given IV | what about the rest

Answer 32

infliximab is given IV | the rest are given SQ

Question 33

lubiprostone indications

Answer 33

IBS-C (women) | chronic idiopathic constipation

Question 34

uses of TNF-a inhibitors

Answer 34

tx of active and maintence | moderate to severe disease, not mild

Question 35

AE glucocorticosteroids

Answer 35

``` increase glucose, bp, and lipid profile gi distress fluid retetnion increased appetite/fat redistribution bone defects insomnia ```

Question 36

side effect of loperamide

Answer 36

constipation, dizziness, drowsiness, urinary retention