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Integrative Exam 3
Topic: Irritable Bowel Syndrome
Terms in this set (58)
What is the brand name of Sulfasalazine?
Azulfidine and Azulfidine EN
What is the brand name of Mesaline Suppository?
What is the brand name of Mesalamine Enema?
What is the brand name of Mesalamine Oral?
Asacol, Apriso, Lialda, Pentasa, Delzicol
What is the brand name of Olsalazine oral?
What is the brand name of Balsalazide Oral?
What is CI with Sulfasalazine, Mesalamine Oral, Balsalazide, and Olsalazine?
CI: salicylate, sulfa allergy
What are some important notes for Sulfasalazine?
May cause urine/skin to turn yellow-orange color; take folate 1 mg/day and caution with patients with G6PD deficiency
What are some important notes for Mesalamine Oral?
Can use topical and oral forms together
Does Corticosteroids have a role in maintenance of IBD?
What is the brand name of Budesonide?
Entocort EC, Uceris
What are some important notes for Budesondie?
major substrate CYP450 3A4: avoid grapefruit juice; they need to be separated by two hours from antacids
Entocort can be used for what type of IBD remission?
Induction and maintenance of remission
Uceris can be used for what type of IBD remission?
Induction of remission
Placement of Azathiprine and 6MP in IBD?
can be used alone or as adjuncts to mesalamine, CS, TNF-alpha for maintenance; should not be used alone for induction of remission
When do you see the benefit of Azathioprine and 6MP in IBD?
few weeks to one year before benefits are observed
Should you give live vaccines to those taking immunomodulators?
Does Methotrexate have steroid sparing effects?
What is the most common side effects of cyclosporine?
Nephrotoxicity and neurotoxicity
What is the brand name of Azathioprine?
Imuran and Azasan
What is the brand name of 6 MP?
What is the brand name of Methotrexate?
Trexall, Otrexup, Rasuvo, Xatmep
What is the brand name of Cyclosporine
Gengraf, Neoral, Sandimmune
what is a common ADR of Azathioprine Mercaptopurine?
Bone marrow suppression and Pancreatitis
What is the common ADR of Methotrexate?
Bone marrow suppression and pancreatitis
What are some monitoring parameters for cyclosporine?
Cyclosporine levels and amongst others
What are some important notes about Azathioprine?
Check TPMT activity (decrease activity means increase risk for myelosuppression) and BBW for malignancy esp. lymphoma
What is the BBW for cyclosporine?
increased risk for infxn, lymphoma
What are the monitoring parameters for methotrexate?
obtain baseline tests prior to start of tx along with chest x-ray
What are some important notes about Methotrexate?
Obtain pregnancy test prior to starting tx if female patient of childbearing age
What are the medications that are xanthine oxidase inhibitors which interact with AZA and 6-MP?
Allopurinol and Uloric (used for gout)
Dose of what gout medication should be reduced by 25%
What gout medication is CI with AZA and 6MP
What Abx is used for IBD?
Metronidazole and Ciprofloxacin and Rifamycin
What is the brand name of Infliximab?
Remicade (TNF-alpha inhibitor)
What is the brand name of Adalimumab?
Humira (TNF-alpha inhibitor)
What is the brand name of Golimumab?
Simponi (TNF-alpha inhibitor)
What is the brand name of Certolizumab?
Cimzia (TNF-alpha inhibitors)
What are some important notes about TNF-alpha inhibitors?
For induction of remission and maintenance therapy--often used 1st line
Which TNF-alpha inhibitors are used for both UC and CD?
Inflixmab and Adalimumab
Which TNF-alpha inhibitor is used for UC only
Which TNF-alpha inhibitor is used for CD only
Which TNF-alpha inhibitor needs to premedicated with antihistamines, APAP, and CS to minimize risk for infusion reactions?
What are some monitoring parameters for TNF-alpha inhibitors?
BP/HR during infusion 12-10 minutes until normal and antidrug antibodies
What are some CI with TNF-alpha inhibitors?
Active infection, latent untreated TB, demyelinating dz such as MS and Optic neuritis, heart failure NYHA class II/IV
What is the BBW of TNF-alpha inhibitors?
What is the brand name of Vedolizumab?
What is the brand name of Natalizumab?
What is the risk associated with Entyvio and Tysabri?
Risk for PML, 1 case observed
What are some important notes about Tysabri?
Must have Negative John Cunningham virus antibody, checked every 6 months
What is the brand name of Usteokinumab?
What is the brand name of Tofacitinib?
What is Stelara indicated for in IBD?
moderate to severe CD/UC
What is an ADR of Stelara?
RPLS despite being rare
What are some notes for Stelara and Xeljanz?
TB test prior to starting therapy and no live vaccines
What is the indication for Xeljanz
What is the ADR for Xeljanz
BBW 10 mg BID dose may increase risk for blood clots and death
What are some comments esp for Xeljanz?
Dose-dependent herpes zoster risk so consider recombinant shingles vaccine
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