Therapeutics: IBD 2

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Author:
kyleannkelsey
ID:
272117
Filename:
Therapeutics: IBD 2
Updated:
2014-04-27 14:50:34
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Therapeutics IBD
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Therapeutics: IBD 2
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Therapeutics: IBD 2
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  1. What is the enema form of Mesalamine?
    Rowena
  2. What is the suppository form of Mesalamine?
    Canasa
  3. What are the capsule forms of Mesalamine?
    • Delzicol
    • Pentasa
    • Apriso
  4. What are the tablet forms of Mesalamine?
    Lialda
  5. What are the formulation of Sulfasalazine and what routes of administration are they available in?
    • Azulfidine (tablet)
    • Sulfazine (tablet)
  6. What are the amino salicylates for IBD?
    • Olsalazine
    • Dipentum
    • Balsalazide
    • Mesalamine
  7. What is the MOA of Amino Salicylates in IBD?
    • Shut down the activity of TNF and Arachadonic acid metabolites
    • Prevent the movement of WBC into the gut
    • Stop inflammatory process
  8. Sulfasalazine is composed of what?
    • Combination of sulfapyridine (antibiotic) and mesalamine (5-aminosalicylic acid)
    • Mesalamine is the active component
    • Cleaved by gut bacteria to the two components
  9. How is Sulfasalazine excreted?
    • Sulfapyridine excreted in urine & thought responsible for most side effect of sulfasalazine
    • Mesalamine excreted in stool
  10. What is Sulfasalazine used when Mesalamine is the active component and is available?
    Sulfasalazine is much cheaper than any mesalamine formulation
  11. What patient population is Sulfasalazine CI in?
    Sulfa Allergy
  12. Why is Mesalamine not used for acute exacerbation of IBD?
    • Acute exacerbation = decreased transit time
    • Less time for formulations to be absorbed or activated
  13. What are the QD Mesalamine products?
    Lialda & Apriso
  14. What are the multiple daily dose Mesalamine products?
    • Delzicol & Pentasa
    • Olsalazine & Balsalazide
  15. What are the Mesalamine products?
    • QD: Lialda & Apriso
    • Multiple Daily doses: Delzicol & Pentasa, Olsalazine & Balsalazide
  16. Why are Mesalamine productsat the bottom of the pyramid (least aggressive/most used) therapy for IBD?
    Potential benefit in reducing risk of colon cancer
  17. When choosing a treatment option for Crohn’s or UC, what would be your first consideration?
    Where the drug acts with relation to the site of disease
  18. Where does Asacol work in the GI?
    Rectum to Terminal ileum

  19. Where does Pentasa work in the GI?
    Rectum to Jejunum (whole GI)

  20. Where does Sulfazalazine/Balsalazide work in the GI?
    Rectum to Proximal colon

  21. Where does Rowena enema work in the GI?
    Rectum to Proximal colon

  22. Where does a Steroid enema work in the GI?
    Recturm to Proximal Comol

  23. Where does Canasa work in the GI?
    Rectum

  24. When would you add Anibiotics as adjunct therapy in IBD?
    • Only for Crohn’s
    • Usually only if perianal fistulas are present
  25. What would be a typical antibiotic therapy for IBD?
    Metronidazole + Ciprofloxacin (Quiolone)
  26. What steroids have acitivity in IBD and when would you use them?
    • Corticosteroids (not sure if local or systemic effects)
    • Only use during active flares (never long term)
  27. What are the routes of administration for in the treatment of IBD?
    • Parenteral
    • Oral
    • Rectal
  28. What is the dose for Prednisone PO in IBD?
    • 40-60 mg/day
    • Taper off after 1-2 months
  29. What is the dose for Budesonide PO
    • 6 or 9 mg/day
    • Taper off after 2-3 months
  30. Why do practitioners often use Budesonide (Entocort) as a maintenance therapy/long term?
    Extensive 1st pass metabolism minimizes systemic exposure
  31. What is the dose for Hydrocortisone/Methylprednisolone IV?
    • 100-125mg IV Q6-8h
    • If successful remission, change to oral prednisone

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