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IBD SE
| Question | Answer |
|---|---|
| arthralgia, dyspepsia, anemia | sulfasalazine |
| increased LFTs, infectious complications, lymphoma | azathioprine |
| hypertrichosis, hyperglycemia, hypertriglycerides, increased infection and lymphoma | cyclosporin |
| interacts with cardiac glycosides and heparin | sulfasalazine |
| decreased effectivity with antacids, PPI, H2 blockers | mesalamine |
| increased bleeding risk with heparin (class) | aminosalicyclates |
| take with food (2) | sulfasalazine and ribavirin |
| supplement with folic acid | sulfasalazine and methotrexate |
| BB warning for malignancy | azathioprine |
| allopurinol increases risk for toxicity | azathioprine |
| contraindicated with antibiotics, anti-convulsants, allopurinols, CCB, grapefruit juice, statins...CYP3A4 pathway | cyclosporin |
| category X (2) | methotrexate and cipro |
| primarily UC | sulfasalazine |
| distal UC and mild-mod Crohns | mesalamine |
| steroid sparing in IBD | azathioprine |
| Crohns>UC for mod-severe maintenance | methotrexate |
| severe refractory UC | cyclosporin |
| mild-moderate Crohns, maintain UC remission | budesonide |
| IBD that fails other treatments | inflixamab |
| may cause infusion reaction, sepsis, serum sickness, TB reactivation | inflixamab |
| BB for UC | natalizumab |
| reactivates JCV | natalizumab |
| used for refractory Crohns disease | ustekinumab |
| causes pruritis, injection site erythema, increased malignancy risk | ustekumab |
| don't use these 2 with other immune suppressants or vaccines | natalizumab and ustekinumab |
| may cause tendon rupture | cipro |
| do not use with warfarin (2) | cipro and flagyl |
| alcohol intolerance | flagyl |
| only used for crohns | natalizumab |
| used for refractory crohns | ustekinumab |
| 1st generation ASA that interferes with prostaglandin synthesis | sulfasalazine |
| inhibits dihydrofolate reductase-->death of T-lymphocytes | methotrexate |
| calcineurin inhibitor, inhibits Tcell signal transduction | cyclosporin |
| inhibits production of IL1, TNF and inflammation molecules | budesonide |
| chimeric monoclonal antibody and anti-TNF | infliximab |
| DNA gyrase inhibitor | cipro |
| inhibits DNA synthesis, bactericidal | metronizadole |
| aldehyde dehydrogenase inhibitor | disulfiram |
| do not use for aerobic bacteria | metronizadole |
| do not take with heparin | aminosalicyclates |