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Maddy - GI II Exam I - some pharm > Pharm - IBD > Flashcards

Pharm - IBD Flashcards

(55 cards)

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1
Q

list the 4 5-ASA drugs used for ulcerative colitis

A
  • sulfasalazine
  • mesalamine
  • olsalazine
  • balsalazide
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2
Q

list the janus kinase (JAK) inhibitors used for ulcerative colitis

A

tofacitinib

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3
Q

list the TNF-a inhibitors used for ulcerative colitis

A
  • adalimumab
  • golimumab
  • infliximab
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4
Q

list the alpha-4 integrin inhibitors used for ulcerative colitis

A

vedolizumab

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5
Q

list the IL-12/23 inhibitors used for crohn disease

A

ustekinumab

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6
Q

list the TNF-a inhibitors used for crohn disease

A
  • adalimumab
  • certolizumab
  • infliximab
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7
Q

list the alpha-4 integrin inhibitors used for crohn disease

A
  • natalizumab

- vedolizumab

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8
Q

what TNF-a inhibitors are used for both UC and CD

A

adalimumab and infliximab

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9
Q

what alpha-4 integrin inhibitors are used for both UC and CD

A

vedolizumab

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10
Q

MOA 5-ASA agents

A

inhibition of prostaglandin and leukotriene production via arachidonic acid pathway
+
reduction in PMN and macrophage chemotaxis

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11
Q

when to use rectal suppositories, rectal enemas, and oral 5-ASA agents

A

rectal suppositories: to reach upper rectum

rectal enemas: to reach the splenic flexure

oral: to reach the entire GI tract

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12
Q

side effects 5-ASA agents

A
  • CNS: dizziness, HA, fatigue

- GI: anorexia, abd pain, N/V/D

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13
Q

sulfasalazine is contraindicated in what patients

A

those with sulfa allergies

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14
Q

all 5-ASA compounds are contraindicated in what patients

A

ASA-allergic patients

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15
Q

indications for 5-ASA agents

A

active AND maintenance of mild to moderate UC

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16
Q

indications for olsalazine (a 5-ASA agent)

A

ONLY for maintenance of remission UC (not active dz)

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17
Q

indications for balsalazide (a 5-ASA agent)

A

ONLY for active dz UC (and only approved in males)

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18
Q

MOA TNF-a inhibitors

A

blocks TNF-a which blocks leukocyte migration to site of inflammation

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19
Q

list the methods of administration of the TNF-a inhibitors for UC and crohn’s

A
  • adalimumab: SQ injection
  • golimumab: SQ injection
  • infliximab: IV injection
  • certolizumab: SQ injection
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20
Q

which TNF-a agent is used ONLY for CD

A

certolizumab

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21
Q

which TNF-a agent is used ONLY for UC

A

golimumab

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22
Q

side effects TNF-a inhibitors

A
  • infections
  • liver toxicity
  • HA/arthralgias/fatigue
  • dermatologic related
  • malignancies
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23
Q

what MUST you do before giving TNF-a inhibitors

24
Q

indications for TNF-a inhibitors

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A

active dz AND management of MODERATE TO SEVERE UC and CD (depending on drug)

25
indications for adalimumab
active and management of moderate to severe UC and CD
26
indications for infliximab
active and management of moderate to severe UC and CD
27
indications for golimumab
active and management of moderate to severe UC only
28
Indications for certolizumab
active and management of moderate to severe CD only
29
when are TNF-a inhibitors used
after inadequate response to conventional or immunosuppressant therapy
30
what is the maintenance dose and administration method for adalimumab
SQ injection every 2 weeks
31
what is the maintenance dose and administration method for infliximab
IV infusion every 8 weeks
32
what is the maintenance dose and administration method for golimumab
SQ injection every 4 weeks
33
what is the maintenance dose and administration method for certolizumab
SQ injection every 4 weeks
34
MOA alpha-4 integrin inhibitors
limits integrin's cell adhesion and transepithelial migration of leukocytes to site of inflammation
35
route of administration for natalizumab
IV injection
36
route of administration for vedolizumab
IV injection
37
compare which integrins are inhibited by natalizumab and vedolizumab
natalizumab: alpha 4 B1 and alpha 4 B7 vedolizumab: just alpha 4 B7
38
side effects alpha-4 integrin inhibitors
infections - progressive multifocal leukoencephalopathy - infusion related reactions - anti-medication antibodies - increased risk of malignancy
39
indications of natalizumab
active dz and maintenance of moderate to severe CD
40
indications for vedolizumab
active dz and maintenance of moderate to severe CD and UC
41
when are alpha-4 integrin inhibitors used
after inadequate response to conventional therapy of TNF-a therapy
42
what is the maintenance dose and administration method for natalizumab
IV infusion every 4 weeks
43
what is the maintenance dose and administration method for vedolizumab
IV infusion every 8 weeks
44
MOA IL-12/23 inhibitors
bind to P40 subunit of IL-12 and IL-23, blocking activation and differentiation of naive T cells and activation of NK cells
45
side effects of ustekinumab (IL-12/23 inhibitor)
- infections - infusion related reaction - HA/arthralgia/fatigue - increase risk of malignancy
46
what must you do before giving IL-12/23 inhibitors
TB testing
47
indications for ustekinumab (IL-12/23 inhibitor)
active dz and maintenance of moderate to severe CD
48
when should you prescribe ustekinumab
when patients are intolerant or have inadequate response to conventional, immune modulators, steroids, or TNF-a therapy
49
what is the maintenance dose and administration method for ustekinumab
SQ injection every 8 weeks
50
MOA janus kinase (JAK) inhibitors
bind to and inhibit free-floating and bound JAK-1 and JAK-3 which inhibits gene transcription and more cytokine release
51
side effects tofacitinib (a JAK inhibitor)
- lymphopenia/lymphocytosis - neutropenia/anemia - fatigue - increases in LDL and HDL - increase risk of malignancy
52
indications for tofacitinib (a JAK inhibitor)
active dz and maintenance of moderate to severe UC
53
what is the maintenance dose and administration method for tofacitinib
PO BID
54
what drugs can patients not take while taking tofacitinib
biologig therapies or potent immunosuppressants
55
describe the use of steroids in treating IBD
used at the lowest dose for the shortest duration possible for acute and/or severe UC or CD NOT for maintenance of remission unless ABOLUTELY required

Maddy - GI II Exam I - some pharm (23 decks)

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