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BCPS study guide
ulcerative colitis and crohn's
| Question | Answer |
|---|---|
| initial treatment for low severity ulcerative colitis | topical aminosalycilates (sulfasalazine or mesalamine) or oral budesonide. can add oral aminosaliycilates if topical is not enough. oral steroids - 40-60 mg PO prednisone equivalent. can use nicotine replacement therapy in ex smokers. |
| once aminosalycilates and steroids have been tried, what is the next step for treatment of ulcerative colitis | if more ill use TNF alpha inhibitors such as infliximab or adalimumab. if less ill can do azathioprine or 6 MP. |
| if TNF or AZA/6MP is not successful what is the next step for treatment of ulcerative colitis | IV steroids - hydrocortisone 300 mg QD or methylpred 60 mg QD. can add TNF alpha if not already on. can also try cyclosporine with or without ASA/6MP unless already on. |
| if medication management is not successful, what is the last option for pts with ulcerative colitis | colectomy |
| initial treatment for low severity Crohn's disease | oral budesonide or aminosalycilates if terminal ileal or ascending colon. can add flagyl/cipro if perianal or colonic. next can add steroid therapy IV followed by TNF alpha and 6MP or AZA once symptoms improve |
| if no response from TNF + 6MP/AZA what is the next option for Crohn's disease | natalizumab (Tysabri) or surgery. can try IV steroids, cyclosporine in the mean time. |
Created by:
mjuhlin
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