Pharmacotherapy for Inflammatory Bowel Disease Quiz
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Questions and Answers

Which treatment is typically recommended as first-line therapy for mild-moderate distal ulcerative colitis?

  • Oral corticosteroids
  • Infliximab
  • IV corticosteroids
  • Sulfasalazine (correct)

What is the appropriate pharmacologic treatment option for proctitis in ulcerative colitis?

  • Budesonide
  • Pancolitis therapy
  • Systemic agents
  • Topical agents (suppository) (correct)

In patients with moderate-severe ulcerative colitis who do not respond to prednisone, what alternative treatments may be considered?

  • Mesalamine
  • Budesonide
  • Sulfasalazine
  • Azathioprine (correct)

What is the site of disease for extensive colitis in ulcerative colitis?

<p>Inflammation extending proximal to the splenic flexure (B)</p> Signup and view all the answers

What is the first-line therapy for mild-moderate extensive ulcerative colitis in active disease?

<p>Sulfasalazine (C)</p> Signup and view all the answers

Which of the following is NOT an appropriate remission/maintenance therapy for mild-moderate distal UC?

<p>Topical or oral corticosteroids (A)</p> Signup and view all the answers

For severe-fulminant ulcerative colitis refractory to IV corticosteroids, what treatment could be considered next?

<p>IV cyclosporine (D)</p> Signup and view all the answers

What is the appropriate pharmacologic treatment option for pancolitis in ulcerative colitis?

<p>Sulfasalazine (B)</p> Signup and view all the answers

What is the recommended pharmacologic approach for refractory ulcerative colitis after attempting IV cyclosporine therapy?

<p>Tapering prednisone (D)</p> Signup and view all the answers

Which treatment option should be considered for maintenance therapy in UC after achieving remission with IV hydrocortisone?

<p>Mercaptopurine (C)</p> Signup and view all the answers

Flashcards

Inflammatory Bowel Disease (IBD)

A chronic gastrointestinal (GI) condition causing gut inflammation, including Ulcerative Colitis (UC) and Crohn's Disease (CD).

Ulcerative Colitis (UC)

A type of IBD causing chronic inflammation of the colon, often leading to rectal bleeding, diarrhea, and abdominal pain.

UC Treatment (Mild-Moderate Distal)

First-line: Topical aminosalicylates (enema/suppository). Mesalamine if needed. May combine oral and topical aminosalicylates.

UC Treatment (Mild-Moderate Extensive)

First-line: Oral aminosalicylate. Options like budesonide (Uceris) or sulfasalazine or mesalamine may be considered.

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UC Treatment (Moderate-Severe)

First-line: Budesonide. Other option: prednisone. Add immunosuppressants (azathioprine, mercaptopurine, biologics) if needed.

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UC Treatment (Severe-Fulminant)

High-dose steroids (methylprednisolone), followed by biologics if needed. Aim for remission and then possibly steroid withdrawal.

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Irritable Bowel Syndrome (IBS)

GI syndrome with chronic abdominal pain and altered bowel habits, without an underlying organic cause.

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IBS Treatment Options

Various medications like linaclotide, rifaximin, tegaserod, or plecanatide are used.

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Factors in UC Pathophysiology

Genetics, motility issues, inflammation, infections, stress, and psychological factors can affect the colon function, processing of signals, and lead to pain and sensitivity.

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UC Treatment - Proctitis

Topical agents (suppositories) typically used as first-line therapy for localized inflammation of the rectum, may be used in combination with other therapies.

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Study Notes

Inflammatory Bowel Disease (IBD)

  • IBD is a chronic GI condition characterized by inflammation of the gut, including Ulcerative Colitis (UC) and Crohn's Disease (CD)
  • UC is a type of IBD characterized by chronic inflammation of the colon

Ulcerative Colitis (UC)

  • Definition: UC is a chronic inflammation of the colon, characterized by rectal bleeding, diarrhea, and abdominal pain
  • Epidemiology:
    • Prevalence: 10% worldwide among adults
    • More predominant in younger patients and women
  • Pathophysiology:
    • Results from altered somatovisceral and motor dysfunction of the intestine
    • Abnormal CNS processing of afferent signals may lead to visceral hypersensitivity
    • Factors contributing to alterations include genetics, motility, inflammation, colonic infections, mechanical irritation, stress, and psychological factors

Treatment of UC

  • Treatment is based on:
    • Type of UC (UC vs CD)
    • Severity (Mild, Moderate, Severe, Fulminant)
    • Site of disease (Proctitis, Distal disease, Extensive disease, Small intestine involvement)
    • Need for acute treatment or maintenance therapy
  • Treatment options:
    • Topical agents (suppository) for proctitis
    • Systemic or topical therapy or combination for distal disease
    • Systemic agents for extensive colitis
    • May add topical therapy if needed/appropriate
  • Mild-Moderate Distal UC:
    • First-line treatment: Topical aminosalicylates (enema/suppository)
    • Mesalamine if inadequate or no response
    • May combine oral and topical aminosalicylates
  • Mild-Moderate Extensive UC:
    • First-line treatment: Oral aminosalicylate
    • Budesonide (Uceris) 9 mg/d
    • Sulfasalazine or Mesalamine
  • Moderate-Severe UC:
    • First-line treatment: Budesonide 9 mg/day
    • Prednisone 40-60 mg/d
    • Add azathioprine, mercaptopurine, infliximab, adalimumab, or golimumab if no response
  • Severe-Fulminant UC:
    • Treatment: Methylprednisolone 40-60 mg daily for 3-5 days
    • IV cyclosporine or infliximab if refractory to IV corticosteroids
    • Add azathioprine, mercaptopurine, infliximab, certolizumab, adalimumab, vedolizumab or tofacitinib if remission achieved
    • Attempt to withdraw prednisone after 1-2 months

Irritable Bowel Syndrome (IBS)

  • Definition: IBS is a GI syndrome characterized by chronic abdominal pain and altered bowel habits in the absence of any organic cause
  • Epidemiology:
    • Prevalence: 10% worldwide among adults
    • More predominant in younger patients and women
  • Pathophysiology:
    • Results from altered somatovisceral and motor dysfunction of the intestine
    • Abnormal CNS processing of afferent signals may lead to visceral hypersensitivity
    • Factors contributing to alterations include genetics, motility, inflammation, colonic infections, mechanical irritation, stress, and psychological factors

Treatment of IBS

  • Treatment options:
    • Linaclotide
    • Rifaximin
    • Tegaserod
    • Plecanatide

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Description

Test your knowledge of pharmacotherapy options for inflammatory bowel disease with this quiz. Learn about medications such as Linaclotide, Rifaximin, Tegaserod, and Plecanatide referenced in the 'DiPiro's Pharmacotherapy: A Pathophysiologic Approach' textbook.

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