Flashcards in Pharm for IBD and IBS Deck (37):
What are the categories of drugs used for UC?
-a-4 integrin ihibitors
What is the "phrase" that helps you identify a 5-ASA for UC
"phrase" in TNF-alpha inhibitors
MAB at the end
what is the one a-4 integrin inhibitor used for UC?
What is the one category of drug used for Crohns and not UC and what does it replace?
IL-12/23 inhibitors in place of the 5-ASAs used for UC
what is the one IL-12/23 inhibitor for CD?
What are the 2 TNF a inhibitors that are used for BOTH UC and CD
What is the 1 TNF a inhibitor only used for UC?
Only for CD?
Certolizumab (C with C)
What is the extra a-4 integrin inhibitor that is used for CD and NOT UC?
-Vedolizumab is used for both
3 routes of administration for 5-ASA and how they relate to extent of UC
-Oral (may be released through GI tract)
-Rectal Enema (may reach splenic flexure)
-Rectal suppository (reach the upper rectum)
MOA of 5-ASA
-inhibition of PG and LT production through COX and LOX pathways (arachindonic acid pathways)
-Reduction of PMN and macrophage chemotaxis
-may also inhibit NFkB
Contraindications for 5-ASAs
-ASA allergic patients
-Sulfasalazine contraindicated in sulfonamide-allergic patients
Indication for 5-ASA agents
-Mild to moderate active UC and maintenance of remission of UC
Which 5-ASA ONLY for maintenance therapy?
ONLY for treatment of active disease?
What is the other thing that sulfasolazine is indicated for?
TNF-a inhibitors are what monoclonal antibodies?
except which one that is a fragment (Fab)?
Side effects of TNF-a inhibitors
-infections . . TB testing pre therapy
Indications for TNF-a inhibitors
Moderate to severe disease . . Active and maintenance
TNF-a inhibitor: route is SQ every other week
TNF-a inhibitor: route is IV infusion every 8 weeks
TNF-a inhibitor: route is SQ every 4 weeks for UC
TNF-a inhibitor: route is SQ every 4 weeks for CD
Side effects for a-4 integrin inhibitors
-Infections . . . PML (progressive multifocal leukoencephalopathy)
What are the risk factors for PML associated with a-4 integrin inhibitor treatment
-Treatment >2 years
-Prior immunosuppressant treatment
-anti-JC virus antibodies (JCV)
Indication for a-4 integrin inhibitors
-moderate to severe treatment resistant CD and UC
-Natalizumab for CD
-Vedolizumab for BOTH
Which a-4 integrin inhibitor is IV every 4 weeks?
IV every 8 weeks?
Side effect of IL12/23 inhibitor
infections - TB testing pre therapy
Indications for IL12/23 inhibitors
moderate to severe treatments resistant CD . . both active disease and maintenance
administration of the IL-12/23 inhibitor Ustekinumab
-IV single infusion or
-SQ every 8 weeks for maintenance
What are the different categories of drugs used for IBS?
-Serotonin (5-HT) antagonists
-Guanylate cyclase-C agonists
-Selective chloride (C2) channel activators
Which IBS category of drugs is used to treat the abdominal pain
What are the 3 antimuscarinics used for IBS?
the 3 categories of IBS drugs that are used for Diarrhea and their specific names
-Anti-diarrheals (Loperamide Diphenoxylate . . Bismuth)
-Opioid Agonist/Antagonist (Eluxadoline)
-Serotonin (5-HT) antagonist (Alosetron)
side effects of Loperamide
-typical anticholinergic effects
Side effects of Alosetron . . 5-HT inhibitor
Indication for Alosetron use
-WOMEN with chronic, severe IBS-D not responsive to other conventional therapies