Term
| What are the major types of iflammatory bowel disease (IBD)? |
|
Definition
Ulcerative Colitis (UC) and Crohn's disease. |
|
|
Term
| Chron's disease can cause? |
|
Definition
malabsorption (vitamin deficiencies) and anal fissures |
|
|
Term
| Ulcerative colitis affects what? And describe signs symptoms. |
|
Definition
UC affects only the rectum and colon with superficial ulcerations. When the disease flares, patients are usually running to the bathroom often, with pain, which can significantly decrease quality of life. |
|
|
Term
| What does Chron's disease affect and how does it present? |
|
Definition
Any part of the GI tract can be affected, although 2/3 of cases are in the ileum - the last part of the small intestine. The GI tract can get swollen and ulcerated |
|
|
Term
| What is the basic treatment for both UC and Crohn's disease in simple cases? |
|
Definition
Antidiarrheal medicines, primarily loperamide (Imodium) 2 mg after each loose stool, up to 8 doses/day. Antispasmodics for UC may be useful. The most common antispasmodic is dicyclomine (Bentyl) given 10 mg AC and QHS.
|
|
|
Term
Regarding acute flare-ups of either UC or Cron's disease, what is the treatment? |
|
Definition
Short courses of oral steroids are used.
More moderate symptoms, aminosalicylates (sulfasalazine or mesalamine)
|
|
|
Term
| What is used in moderate-severe cases of Crohn's disease? |
|
Definition
Immunosuppressive agents:
azathioprine
6-mercaptopurine
methotrexate |
|
|
Term
| What is used in severe UC or Crohn's cases? |
|
Definition
Maybe: Infliximab (TNF-blockers)
Occasionally: IV steroids or cyclosporine
|
|
|
Term
| Name some natural products used to treat UC and Crohn's Disease |
|
Definition
Natural Stimulant Laxatives:
Cascara
Senna
For Diarrhea:
psyllium (in Metamucil)
Antispasmodic:
Peppermint oil
Chamomile Tea
|
|
|
Term
| Why are steroids use for acute flares? |
|
Definition
Steroids are not supposed to be used long-term
If used long-term assess bone density, consider use of bisphosphonates, optimize calcium and vitamin D intake
If used longer than 2 weeks taper dose off to avoid withdrawal symptoms
|
|
|
Term
| Brand name for budesonide used to treat acute inflammatory symptoms |
|
Definition
|
|
Term
|
Definition
| Statement. Not a question. |
|
|
Term
| What kind of substrate is Budesonide? |
|
Definition
|
|
Term
| What is 1st line for UC mild-mod distal disease? |
|
Definition
Enema or rectal mesalamine suppositories
|
|
|
Term
| Brand name for Mesalamine |
|
Definition
|
|
Term
| What does mild-mod cases of Crohn's disease require? |
|
Definition
oral therapy with mesalamine or sulfasalazine |
|
|
Term
| What is 1st line in UC mild-mod extensive disease? |
|
Definition
|
|
Term
|
Definition
| Statement. Not a question. |
|
|
Term
|
Definition
| Statement. Not a question. |
|
|
Term
|
Definition
| Statment. Not a question. |
|
|
Term
| What do all TNF inhibitors carry as a black box warning? |
|
Definition
warning for risk of serious infections, including tuberculosis, and invasive fungal and other oppotunistic infections.
All patients should be evaluated before starting TNF drugs |
|
|
Term
| Does mesalamine result in a ghost tablet? |
|
Definition
Yes. Patients may see a ghost tablet in teh feces (Asacol HD) |
|
|
Term
| Explain how to use the Rowasa enema |
|
Definition
|
|
Term
| Explain how to use canasa suppository |
|
Definition
|
|
Term
| How to take Budesonide (Entocort EC) |
|
Definition
Take with full glass of water before a meal. Do not crush, chew or break open the capsule |
|
|
Term
| Should blood pressure be monitored whilst on budesonide? |
|
Definition
No, blood glucose ("blood sugar") should be monitored
|
|
|
Term
| Contraindicaiton for sulfasalazine |
|
Definition
Do not use if you have an allergy to sulfa or salicylates |
|
|
Term
| Name some side effects of sulfasalazine |
|
Definition
(1) use protection if you are out i the sun (clothing, sunscreen) as you patients will burn more easily
(2) May make the urine or skin turn an orange-yellowish color |
|
|
