Small & large intestine pharmacology II

Question 1

Does ulcerative colitis or Crohn’s disease involve type 1 helper T cells?

Answer 1

Crohn’s

Question 2

Does ulcerative colitis or Crohn’s disease involve type 2 helper T cells?

Answer 2

Ulcerative colitis

Question 3

How do 5-ASA agents treat IBD?

Answer 3

Have anti-inflammatory activity

inhibits arachidonic acid cascade

Question 4

This 5-ASA agent may cause non-bloody diarrhea due to increased secretion of fluid in the small bowel

Answer 4

Olsalazine

Question 5

This IBD drug is not recommended for patients with active diarrhea where drug-induced diarrhea is contraindicated

Answer 5

5-ASA agents
(esp olsalazine)

Question 6

This IBD drug may cause oligospermia and infertility in men

Answer 6

5-ASA

Question 7

This IBD drug may cause hepatitis, neuropathy, folate deficiency with long term use, and blood dyscrasias

Answer 7

5-ASA

Question 8

Budesonide is this type of drug for IBD

Answer 8

Glucocorticoid

Question 9

Sulfasalazine is this type of drug for IBD

Answer 9

5-ASA agent

Question 10

Olsalazine is this type of drug for IBD

Answer 10

5-ASA agent

Question 11

Does Budesonide have glucocorticoid side effect?

Answer 11

Minimal

is a Synthetic corticosteroid
(Potent glucocorticoid and Mild mineralocorticoid)

Question 12

These are purine analogues commonly employed in the management of glucocorticoid-dependent IBD

Answer 12

Azathioprine and 6-Mercaptopurine

Question 13

A patient with IBD who cannot tolerate glucocorticoids could be given either of these drugs

Answer 13

Azathioprine and 6-Mercaptopurine

Question 14

This antibody binds TNFa and prevents it from binding to its receptor
Is generally well tolerated; primary problem is infusion related reactions

Answer 14

Infliximab

Question 15

This anti-TNF therapy may cause congestive heart failure exacerbation, increased risk of cancers in adolescents (black box), and patient should be screened for tuberculosis before starting therapy

Answer 15

Infliximab

Question 16

This is the black box warning for infliximab

Answer 16

Increased risk of cancer in adolescent

Question 17

These anti-TNF therapies for IBD are recombinant monoclonal IgG1 antibody that result in decreased immunogenicity

Answer 17

Adalimumab and Golimumab

Question 18

This IBD therapy is a pegylated form of an anti-TNF Fab portion of an antibody

Answer 18

Certolizumab pegol

Question 19

This anti-TNF therapy is effective for induction of clinical response in patients with active inflammatory Crohn’s disease

Answer 19

Certolizumab pegol

Question 20

This IBD therapy should be used to induction of clinical response in patients with active inflammatory Crohn’s disease

Answer 20

Certolizumab pegol

Question 21

This IBD therapy is a lipophilic peptide with inhibitory effects on both the cellular and humoral immune systems

Answer 21

Cyclosporine

Question 22

Do azathioprine and 6-MP have a more rapid onset than cyclosporine?

Answer 22

No - cyclosporine has more rapid onset

Question 23

Natalizumab is this type of therapy for IBD

Answer 23

Anti-integrin

Question 24

Vedolizumab is this type of therapy for IBD

Answer 24

Anti-integrin

Question 25

Certolizumab is this type of therapy for IBD

Answer 25

Anti-TNF

Question 26

Golimumab is this type of therapy for IBD

Answer 26

Anti-TNF

Question 27

This type of therapy is for patients with refractory Crohn's disease or those that are intolerant to anti-TNF therapy

Answer 27

Anti-integrins (Natalizumab and Vedolizumab) are a last resort

Question 28

Loperamide and Eluxadoline treat this type of IBS

Answer 28

IBS-diarrhea predominant (IBS-D)

Question 29

Loperamide is this type of drug for IBS-D

Answer 29

Opioid agonist

Question 30

Does loperamide have CNS effects?

Answer 30

Minimal

Question 31

This is the firstline therapy for IBS-diarrhea predominant

Answer 31

Loperamide

Question 32

Loperamide should be avoided in patients with this

Answer 32

Hepatic insufficiency

Question 33

This is the main side effect of loperamide

Answer 33

Toxic megacolon

Question 34

Eluxadoline is this type of drug for IBS-D

Answer 34

Opioid agonist

Question 35

Does Eluxadoline have CNS effects?

Answer 35

Mild

Question 36

This IBS-D therapy may cause hepato-pancreatic sphincter of Oddi spasm in patients who have undergone a cholecystectomy

Answer 36

Eluxadoline have increased pancreatitis risk

Question 37

Eluxadoline should be avoided in patients with this

Answer 37

Hepatic insufficiency

Question 38

Lubiprostone and Linaclotide can treat this form of IBS

Answer 38

IBS-constipation predominant (IBS-C)

Question 39

This IBS-C treatment is a GC-C agonist Minimal side effects and very tolerable

Answer 39

Plecanatide

Question 40

Plecanatide is an agonist to this is used to treat IBS-C

Answer 40

GC-C

Question 41

This IBS-C treatment is a serotonin agonist that has been withdrawn due to increased risk of serious cardiovascular events

Answer 41

Tegaserod

Question 42

This IBS-C treatment inhibits NHE3, which transports luminal sodium in exchange for cellular protons

Answer 42

Tenapanor

Question 43

Tenapanor is a treatment for IBS-C, and it inhibits this

Answer 43

NHE3 (sodium and H+ exchanger)

Question 44

This IBS-C treatment should not be used in suspected mechanical bowel obstruction Also should not be used in children

Answer 44

Tenapanor

Question 45

This is the main adverse effect of Tenapanor, an IBS-C therapy

Answer 45

Diarrhea discontinue if severe diarrhea occurs, followed by rehydration

Question 46

This IBS-C treatment should be discontinued if severe diarrhea occurs, followed by rehydration

Answer 46

Tenapanor