IBD Treatments Flashcards
(29 cards)
Five drug classes for ulcerative colitis
5-ASA, JAK Inhibitors, TNFa inhibitors, IL-12/23 inhibitors, a-4 integrin inhibitors
Three drug classes for Crohn Disease
IL-12/23 inhibitors, TNF-a, a-4 integrin inhibitors
MOA 5-ASA agents
inhibit prostaglandin and leukotriene production via arachodonic acid pathway, block COX and LIPOX; reduce PMN and macrophage chemotaxis
5-ASA agents
sulfasalazine, mesalamine, olsalazine, balsalazine
5-ASA side effects
CNS and GI related
Contraindications for 5-ASA compounds
ASA allergy, sulfonamide allergy
Indications for 5-ASA
Mild-to-moderate UC; olsalazine is only for maintenance, balsalazide only for active disease
TNF-a inhibitor MOA
bind and inhibit TNF-a to decrease leukocyte migration (VCAM and E-selectin not upregulated
TNF-a inhibitor administered by IV
Infliximab
TNF-a inhibitor side effects
infections, liver toxicity, EM, SJS, TEN, malignancies
Indications for adalimumab
moderate to severe UC and CD
Indications for infliximab
CD and UC
Indications for certolizumab
moderate-to-severe CD only
Indications for golimumab
moderate-to-severe UC only
a-integrin action
adhesion molecules, bind to E-selectin and VCAM, leukocyte adhesion
a-integrin inhibitor MOA
limit integrin-associated cell adhesion, natalizumab binds both a4B1 and a4B7, vedolizumab binds only a4B7
a-integrin inhibitor drugs
natalizumab and vedolizumab
Side effects a-integrin inhibitiors
infections, especially PML(black box warning)
Natalizumab indications
active and maintenance of moderate-to-severe CD
Vedolizumab indications
active and management of moderate-to-severe CD and UC
IL-12/23 inhibitors MOA
bind to P40-subunit of IL-12 and 23 blocking activation of naive T cells and NK cells
IL inhibitor drug
Ustekinumab
IL inhibitor side effects
infections (TB)
IL inhibitor indications
moderate-to-severe UC and CD, for patients
