Unit 1-Drugs Used To Treat UC And CD Flashcards Preview

PHARMACOLOGY SPRING 2018 > Unit 1-Drugs Used To Treat UC And CD > Flashcards

Flashcards in Unit 1-Drugs Used To Treat UC And CD Deck (48):
1

Location of UC

Colon and rectum (continuous pattern)

2

What should you test for when taking azathioprine and 6-MP?

Thiopurine methyltransferase (TPMT)-this enzyme metabolizes azathioprine to 6-MP...needs to be in an active state to work, can lead to toxicity from azathioprine if not converted.

3

Why do we use aminosalicylates?

Induce and maintain remission in MILD to MODERATE IBD

4

Adverse effect of natalizumab.

Progressive multi focal leukoencephalopathy

5

Location of CD

Mouth to anus (discontinuous)

6

When would you use cyclosporine for IBD patients?

With fulminant or refractory symptoms in active disease.

7

If patient is on sulfasalazine and pregnant, what should you give?

Supplement w/1mg folic acid 2x/day-b/c it depletes folate

8

If patient with IBD has pouch it is or CD with resection or perinatal fistula what antibiotic might you use?

Metronidazole

9

Characterized by acute and chronic inflammation of GI tract.

UC and CR (IBDs)

10

What should you avoid with IBD?

Antidiarrheal meds that reduce GI motility.-risk precipitating acute clinic dilation (toxic mega colon)

Anticholinergic drugs-toxic megacolon

NSAIDS-can worsen IBD six

Caution with OPIODS-toxic megacolon

11

Does UC extend beyond the submucosal layer?

No

12

Azathioprine

Immunosuppressant

13

Oslsalazine

Aminosalicylates

14

Which aminosalicylates is the least tolerated?

Sulfasalazine

15

MOA of methotrexate

Folate antagonist

16

Use of Azathioprine and 6-MP.

Maintain remission of IBD.

Reduce need for long term use of corticosteroids

17

MOA of azathioprine and 6-mercaptopurine

Inhibit purine synthesis and reduce IBD-associated GI inflammation

18

Biologics(-mabs)

Immunosuppressants

19

What do you want to screen for before using biologics in IBD?

Latent TB and latent hepatitis.

20

Which disease has to do with the “depth” and penetration of transferral disease?

Crohn disease.

21

First line for moderate to severe active UC.

Biologics-inflict about, adalimumab, golimumab
-if PI therapies (mesalamine, sulfasalazine) don’t work

Azathioprine or 6-MP
-if unresponsive to corticosteroids
-may be combined with infliximab

22

Adverse effects of corticosteroids used long term in IBD.

Cataracts
Skin atrophy
HTN
Hyperglycemia
Adrenal suppression
Osteoporosis
Inc. risk of infection
Delayed growth in children.

23

Can you take methotrexate during pregnancy?

No-category x

24

Mesalamine

Aminosalicylates

25

MOA of aminosalicylates

Provides anti-inflammatory effects to areas of inflammation in GI tract.

26

How long do azathioprine and 6-MP take to work?

3-12 mo

27

First line for mild to moderate active UC.

Oral or topical aminosalicylate derivatives or oral budesonide

28

Use of methotrexate (in terms of IBD).

Maintaining remission of CD.

Reduce steroid use.

29

In UC ________cells produce __________.

Atypical type 2 T helper cell.s

Pro inflammatory cytokines.

30

First line for moderate to severe active CD.

Oral corticosteroid and biologics (can be combined with azathioprine)

31

Which topical med is best used for inducing remission in mild-mod active UC?

Topical mesalamine

32

First line for tax severe to fulminant active CD.

Hospitalize!
IV corticosteroid
Biologics may be used.

33

Contraindication for sulfasalazine

Sulfa allergy

34

Immunosuppressant used to prevent organ rejection in transplant patients.

Cyclosporine

35

Supplements for IBD

B12, folic acid, fat soluble vitamins, iron

36

What cytokines cell plays a major role in CD?

TNF-alpha: activates macrophages, procoagulant, increased production of metalloproteinases in mucosal cells, also stimulates more production of TNF-alpha.

37

Major adverse effects of biologics in IBD

Deactivation of serious infections (TB, hepatitis B).

Exacerbation of heart failure

Lymphoma, including hepatosplenic T-cell lymphoma (rare)
-highest risk in younger males and those using azathioprine or 6-my

38

If a patient with IBD has refractory active DC what antibiotic would you use?

Ciprofloxacin

39

What should you assess in IBD/

Risk of bone loss (calcium + vitamin D supplementation in pots on long term corticosteroids)

40

Cyclosporine

Immunsuppressant

41

Balsalazide

Aminosalicylates

42

Adverse effects of methotrexate.

Hepatotoxicity

Pulmonary fibrosis

Bone Marrow suppression

43

6-mercaptopurine

Immusuppressant

44

Which aminosalycilate causes the most secretory diarrhea?

Olsalazine

45

Sulfasalazine

Aminosalicylates

46

How long may it take for remission to occur in first line treatment for active UC?

4-8 weeks

47

Methotrexate

Immunosuppressants

48

In CD what cause inflammation?

T-helper type 1 cells that produce cytokines