10. Drugs for Inflammatory bowel diseases (IBD) - Pharm

• (Mesa) Mesalamine (5-ASA) - used as inital therapy in UC

  • absorbed in proximal part of the intestine
• 5-ASA MOA - anti-inflammation and alter immune response

  • inhibit cytokines synthesis
  • inhibit leukotrienes and prostaglandin synthesis
• Mesa -pH dependent

  • need to be co-administer with drugs that increase pH
  • PPI and H2 receptor agonist
• (Sulfa) Sulfasalazine - needs to be converted to active form by bacteria enzymes
• Sulfa Ade - cause photosensitivity - avoid UV light
• sulfa can cause sulfa toxicity (C/I)
• Sulfa ADE

  • photosensitivity
  • steven Johnson syndrome
  • azoospermia
• immunosuppressant - Azathio and 6MP

  • inhibit purine synthesis
• immunosuppressant use as maintenance of remission of UC or crohn
• immunosuppressant - increase the risk of developing lymphoma
• antimicrobials

  • metron
  • cipro
  • rifaxi
• antimicrobial uses

  • crohn disease
  • IBD in pediatrics
• Do not use antibiotics in?


  UC
• 5 ASA - use only in mild to moderate UC

  • combine with glucocorticoid for severe
• Olsa + balsa - less toxic and least drug interaction

  • used for IBD