IBD Pharm (Quiz 4)

Question 1

Aminosalicytes are used for what severity and condition

Answer 1

• mild ulcerative colitis

Question 2

thiopurines are used for what severity

Answer 2

• moderate disease

Question 3

biologics are used for what severity

Answer 3

• severe disease

Question 4

we use steroids for what kind of therapy

duration and dose?

Answer 4

• short term bridge therapy

- short duration and lowest dose

Question 5

we use surgery for what in IBD

Answer 5

• medically refractory disease
• complications
• cancer/dysplasia of bowel

Question 6

what is induction therapy

Answer 6

• treating the flare

Question 7

what is maintenance therapy

Answer 7

• long term treatment

Question 8

do we use corticosteroids for induction or maintenance

do we use it for Chrons or ulcerative colitis

Answer 8

• induction only

- both

Question 9

for corticosteroids need to _______ to prevent renal insufficiency

Answer 9

• taper off

Question 10

MOA for corticosteroids

Answer 10

• enter cell nucleus and influence DNA gene expression
• anti-inflammatory effects
• immune suppression

Question 11

how do you take prednisone

Answer 11

• orally

Question 12

Budesonide is what kind of medication

Answer 12

• steroid

Question 13

Budesonide enteric capsules have _______ release

Answer 13

• ileal

Question 14

Budesonide multimatrix has _______ release

Answer 14

• colonic

Question 15

importance of Budesonide with enterohepatic circulation

Answer 15

• has rapid first pass metabolism

- less systemic effects

Question 16

side effects of corticosteroids

Answer 16

• osteoporosis
• immune suppression/infection
• weight gain

Question 17

do we use aminosalicytes for induction or maintenance therapy

for what condition

Answer 17

• both

- ulcerative colitis

Question 18

medications that are aminosalicylates

Answer 18

• 5-aminosalicylic acid
• sulfasalazine
• balsalazine
• olsalazine

Question 19

MOA of aminosalicylates

Answer 19

• topical anti-inflammatory agent in GI tract

Question 20

rare side effects of aminosalicylates

Answer 20

• pancreatitis

- interstitial nephritis

Question 21

we use oral delayed release capsules of aminosalicylates for what location

Answer 21

• entire colon

Question 22

we use rectal enema of aminosalicylates for what location

Answer 22

• up through sigmoid colon

Question 23

we use rectal foam of aminosalicylates for what location

Answer 23

• entire rectum

Question 24

we use rectal suppository of aminosalicylates for what location

Answer 24

• anus

Question 25

what drugs are the thiopurines

Answer 25

- azathioprine - 6-mercaptopurine - methotrexate

Question 26

speed of azathioprine,6-MP

Answer 26

- slow

Question 27

do we use azathioprine,6-MP for induction or maintenance?

Answer 27

- maintenance

Question 28

if we need to use azathioprine,6-MP for induction, what do we need to do first

Answer 28

- steroid bridge

Question 29

MOA of azathioprine,6-MP

Answer 29

- inhibits nucleotide synthesis | - prevent proliferation of B and T lymphocytes

Question 30

measure ______ levels to guide dosing/therapy of azathioprine,6-MP

Answer 30

- 6-TGN

Question 31

side effects of azathioprine,6-MP

Answer 31

- bone marrow suppression | - cancer risk

Question 32

what kind of cancer can azathioprine,6-MP cause

Answer 32

- lymphoma | - nonmelanoma skin cancer

Question 33

methotrexate MOA

Answer 33

- interferes with purine DNA synthesis

Question 34

big side effect of methotrexate

Answer 34

- teratogenic in pregnancy

Question 35

how do we administer monoclonal antibodies

Answer 35

- IV infusion | - subcutaneous injection

Question 36

problem with monoclonal antibodies and patient immune system

Answer 36

- immune system can make Ab against drug and neutralize it

Question 37

Anti-TNF monoclonal antibodies

Answer 37

- infliximab - adalimumab - certolizumab - golimumab

Question 38

gold standard therapy for moderate to severe IBD

Answer 38

- anti-TNF meds

Question 39

which Anti-TNF alpha med is used for UC only

Answer 39

- Adamlimumab

Question 40

which anti-TNF alpha med is used for Chrons only

Answer 40

- certolizumab pegol

Question 41

MOA of anti-TNF biologics

Answer 41

- inhibits T cell activation

Question 42

do we use anti-TNF meds for induction or maintenance

Answer 42

- both

Question 43

risks of anti-TNF meds

Answer 43

- infection - lymphoma/melanoma - exacerbation of heart failure

Question 44

what is the first gut targeted medication for IBD

Answer 44

- vedolizumab

Question 45

MOA of vedolizumab

Answer 45

- gut selective integrin inhibitor | - white cell can't migrate into gut tissue

Question 46

do we use vedolizumab for induction or maintenance therapy

Answer 46

- both

Question 47

vedolizumab risks

Answer 47

- very little immunosuppression risk

Question 48

Ustekinumab used for UC or Crohns induction or maintenance

Answer 48

- Crohns only | - both

Question 49

MOA of Ustekinumab

Answer 49

- inhibits p40 of IL12 and IL23 | - inhibits downstream JAK/STAT

Question 50

Ustekinumab risks

Answer 50

- systemic immune suppression/infection

Question 51

Tofacinitib used for UC/Crohns induction or maintenance

Answer 51

- UC only | - both

Question 52

is Tofacinitib an antibody MOA

Answer 52

- no | - inhibits JAK/STAT signaling pathway

Question 53

in what form do we give Tofacinitib

Answer 53

- tablet

Question 54

risks of Tofacinitib

Answer 54

- systemic immune suppression/infection | - elevated cholesterol and LFTs