IBD Pharm

Question 1

Drug Classes Used For Ulcerative Colitis (4)

Answer 1

5-ASA Agents
Janus Kinase Inhibitors
TNF-alpha Inhibitors
alpha-4 Integrin Inhibitors

Question 2

Drug Classes Used for Crohn’s Disease (3)

Answer 2

IL 12/IL 23 Inhibitors
TNF-alpha Inhibitors
alpha-4 Integrin Inhibitors

Question 3

5 ASA Agents

MOA (2), Examples (4) and Routes of Administration (3)

Answer 3

Inhibits Prostaglandin/Leukotriene production in arachidonic acid pathway
Reduces immune cell chemotaxis

Mesalamine
Sulfasalazine
Olsalazine
Balsalazide

Oral
Rectal Suppository
Rectal Enema

Question 4

5 ASA Agents

Indications (3), Adverse Effects and Contraindications (2)

Answer 4

Used for Mild-Moderate active and maintanence of Ulcerative Colitis
Olsalazine only for maintenance
Balsalazide only for active

Mild GI/CNS disturbances

Salicylate (ASA) allergies
Sulfa allergies (sulfasalazine)

Question 5

TNF-alpha Inhibitors

MOA, Indications (2), Adverse Effect and Delivery (2)

Answer 5

Block signaling to decrease immune cell chemotaxis

Active and Maintenance of moderate-severe UC/CD

Flare up of Tb infection in affected individuals

Infliximab delivered IV every 8 weeks
Other 3 delivered SubQ every 2-4 weeks

Question 6

TNF-alpha Inhibitor Examples

For Ulcerative Colitis (3) For Crohn’s Disease (3)

Answer 6

Adalimumab
Infliximab (IV)
Golimumab

Adalimumab
Infliximab (IV)
Certolizumab

Question 7

alpha-4 Integrin Inhibitors

Examples with Indications and MOAs (2)

Answer 7

Natalizumab
Used for active/maintenance of moderate-severe CD
Blocks alpha-4, Beta-1 and Beta-7 integrins

Vedolizumab
Used for active/maintenance of moderate-severe UC and CD
Blocks alpha-4 and Beta-7 integrins

Question 8

alpha-4 Integrin Inhibitors
General MOA (2) and Adverse Effects (2)

Answer 8

Blocks integrins to stop leukocyte adhesion and migration

Progressive Multifocal Leukoencephalopathy
Infusion reactions

Question 9

Interleukin 12 and Interleukin 23 Inhibitors

MOA (3), Example with Dosing, Adverse (2) and Indication

Answer 9

Bind P40 subunit to stop T cell differentiation and NK cell activation

Ustekinumab
SubQ every 8 weeks

Flare up of Tb infection in affected individuals

Active and Maintenance of moderate-severe Crohn’s Disease

Question 10

Janus Kinase (JAK) Inhibitors
MOA (2), Example with Dosing, Adverse and Indication

Answer 10

Bind free or bound JAK1/JAK3 to decrease pro-inflammatory gene transcription

Tofacitinib
Oral, BID

Leukopenia and Neutropenia

Active and Maintenance of moderate-severe Ulcerative Colitis

Question 11

Steroid Agents

Indication (2) and Dosing (2)

Answer 11

Acute or severe Ulcerative Colitis or Crohn’s Disease that is refractory to treatment
(not maintenance unless absolutely required)

Use smallest dose possible for shortest time possible