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Questions and Answers
What is a common side effect that should be monitored when administering monoclonal antibody drugs?
What route should ustekinumab (Stelara) be administered?
Which type of vaccines should patients on ustekinumab avoid?
What is a potential infection to monitor for in patients taking interleukin-12/23 inhibitors?
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What effect do Janus-Associated Kinase Inhibitors have on immune cell activity?
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Which medication needs to be assessed for hypersensitivity to sulfonamides or salicylates before administration?
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What should be monitored in patients receiving biologic therapies such as TNF inhibitors?
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Which of the following is NOT a common adverse effect of 5-aminosalicylic acid derivatives?
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How should corticosteroids administered as an enema be taken according to the guidelines?
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What is the primary action of biologic therapies like adalimumab in treating intestinal inflammation?
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Which of the following is a key characteristic of integrin antagonists in treating intestinal conditions?
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When administering oral forms of 5-ASA derivatives, how much water should be used?
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What is an important follow-up when administering 5-ASA derivatives to evaluate their effectiveness?
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Study Notes
5-Aminosalicylic Acid (5-ASA) Derivatives
- Examples: balsalazide (Colazal), mesalamine (Apriso, Asacol, Delzicol, Lialda, Pentasa), olsalazine (Dipentum), sulfasalazine (Azulfidine)
- Work by inhibiting inflammatory mediators in the intestines, such as leukotrienes and tumor necrosis factor.
- Are metabolized by bacteria in the intestines to an active form that acts locally on inflamed areas.
- Available in oral, enema, or suppository forms.
- Assess for contraindications in patients with a history of hypersensitivity to sulfonamides or salicylates, or intestinal or urinary tract obstruction.
- Monitor for possible adverse effects including headache, diarrhea, dizziness, rhinitis, sinusitis, skin rash, and pruritus.
Corticosteroids
- Examples: budesonide (Entocort, Uceris), hydrocortisone (Colocort, Cortenema), prednisone (Prednisone Intensol), prednisolone (Orapred, Pediapred)
- Suppress immune system activity and leukocyte migration.
- Available in oral time-release forms (dissolving in the ileum and colon) or as enemas for topical action.
- Monitor for signs of headache, acne, infections, and Cushing's disease.
Biologic Therapies: Tumor Necrosis Factor (TNF) Inhibitors
- Examples: adalimumab (Humira), certolizumab (Cimzia), golimumab (Simponi, Simponi Aria), infliximab (Inflectra, Remicade, Renflexis)
- Interrupt endogenous tumor necrosis factor alpha (TNFα) to suppress inflammation in the intestine.
- Are monoclonal antibodies.
- Administered subcutaneously, rotating injection sites.
- Monitor for signs of infection or cancer.
- Monitor for possible side effects, including headache, skin rash, positive ANA titer, and increased creatine phosphokinase.
Integrin Antagonists (Alpha-4 Integrin Inhibitors)
- Examples: natalizumab (Tysabri), vedolizumab (Entyvio)
- Bind with the adhesion molecule alpha-4 integrin to prevent leukocyte migration to the intestine.
- Are monoclonal antibody drugs.
- Administered intravenously.
- Monitor for signs of infection.
- Monitor for possible side effects of headache, nausea, fatigue, depression, and skin rash.
Interleukin-12/23 Inhibitors
- Example: ustekinumab (Stelara)
- Bind to inflammatory substances interleukin-12 and interleukin-23 to prevent activation of natural killer cells and tumor necrosis factor.
- Administered subcutaneously, rotating injection sites.
- Monitor for infections, especially TB and fungal infections.
- Monitor for headache, nausea, fatigue, depression, and skin itching.
- Educate patients about vaccines; they should not receive live vaccines while on ustekinumab, and non-live vaccines may not be effective.
Janus-Associated Kinase (JAK) Inhibitors
- Example: tofacitinib (Xeljanz)
- Inhibit intracellular JAK enzymes that stimulate immune cell activity, natural killer cells, immunoglobulins, and B cells.
- Administered orally.
- Monitor for side effects of infection.
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Description
This quiz covers the pharmacological details of 5-Aminosalicylic Acid (5-ASA) derivatives and corticosteroids used in the treatment of inflammatory bowel disease (IBD). Learn about their mechanisms of action, examples, forms, contraindications, and potential adverse effects. Test your knowledge of these important medications.
