Shared Flashcard Set

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IBS and IBD
Crap and more crap
56
Other
Not Applicable
11/04/2012

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Cards

Term
Chronic abdominal pain and altered bowel habits in the absence of any organic cause
Definition
irritable bowel syndrome
Term
ulcerative colitis and crohn's disease
Definition
inflammatory bowel disease
Term
IBS Epidemiology
Definition
females affected more commonly, poorly understood and difficult to treat
Term
IBS Signs/symptoms
Definition
abdominal pain, altered bowel habits, GERD, nausea, impaired sexual dysfunction, urinary symptoms, fibromyalgia
Term
IBS Criteria
Definition
improvement with defecation, onset associated with a change in frequency of stood, onset associated with change in form of stool
Term
IBS subtypes
Definition
with diarrhea, with constipation, mixed
Term
Dicyclomine, Hyocyamine
Definition
Anticolinergics/antimuscarinics
Term
Reduce gastric secretion and GI motility
Definition
Dicyclomine and Hyocyamine
Term
Dicyclomine and Hyoscyamine AEs
Definition
blurred vision, dry mouth, urinary retention, constipation, tachycardia, dizziness, drowsiness, confusion
Term
considered by the FDA as possibly effective, caution with elderly
Definition
Chlordiazepoxide/Clidinium
Term
Chlordiazepoxide/Clidinium AE
Definition
similar to dicyclomine plus benzo side effects
Term
Antidiarrheal for IBS-D -- slows GI motility
Definition
Loperamide
Term
Chloride channel activator-- increases intestinal fluid secretion
Definition
Lubiprostone
Term
Recurring episodes of inflammation limited to the mucosal layer of the colon
Definition
Ulcerative Colitis
Term
Transmural inflammation that may affect the entire GI tract
Definition
Crohn's Disease
Term
Crohn's Disease
Definition
skip lesions rather than continuous disease
Term
Lessens risk of UC
Definition
smoking
Term
Increases risk of CD
Definition
smoking
Term
may increase risk for IBD and exacerbate underlying IBD
Definition
NSAIDs
Term
ulcerative proctitis
Definition
rectum
Term
left-sided UC
Definition
diseases extends to splenic flexure
Term
extensive-colitis
Definition
beyond splenic flexure but sparing the cecum
Term
pancolitis
Definition
to cecum
Term
signs/symptoms of UC
Definition
intermittent bloody diarrhea, rectal urgency, tenesmus
Term
feeling that you need to defecate even when bowel is empty
Definition
Tenesmus
Term
Treatment of UC
Definition
5-ASA compounds, prednisone, CSA, azathioprine, mercaptopurine, infliximab
Term
CD
Definition
often causes sinus tract formation and fistulae
Term
CD treatmetns
Definition
Oral 5-ASA, antibiotics, glucocorticoids, immunomodulators, biologic therapies
Term
5-ASA compounds
Definition
Sulfasalazine, Mesalamine
Term
Inhibits COX--> reduced productin of prostaglandins-->reduced colonic inflammation; also inhibits leukotriene synthesis
Definition
5-ASA
Term
reaches colon intact, cleaved to sulfapyridine + 5-ASA, use in disease confined to colon
Definition
Sulfasalazine
Term
Mesalamine preparation:
Definition
Asacol, Pentasa, Lialda
Term
Released at pH >7 (terminal ileum and colon); useful in UC and ileocecal/colonic CD
Definition
Asacol
Term
Time and pH dependent release from Duodenum to the ileum; indicated for induction of remission and treatment of UC but also useful in diffuse CD
Definition
Pentasa
Term
Time and pH dependent release evenly throughout the colon; induction and maintenance of remission in UC
Definition
Lialda
Term
dosed three times daily
Definition
Asacol
Term
dosed four times daily
Definition
pentasa
Term
once daily dosing advantage
Definition
lialda
Term
Used when 5-ASA compounds are indadequate
Definition
Glucocorticoids
Term
Glucocorticoids
Definition
Response usually seen in 7-10 days
Term
Glucocorticoids AE
Definition
GI upset, agitation, insomnia, edema, hyperglycemia
Term
Budesonide Capsules
Definition
Entocort-EC
Term
poor systemic absorption, fewer adverse effects (but expensive!)
Definition
Budesonide capsules 3
Term
metabolite of azathioprine
Definition
6-MP
Term
suppress T-cell activation/antigen recognition
Definition
6-MP and azathioprine
Term
6-MP and Azathioprine:
Definition
delayed onset (1-4 months), bone marrow suppression, heaptotoxicity and pancreatitis
Term
Methotrexate
Definition
hepatic fibrosis, bone marrow suppression, pneumonitis
Term
CSA
Definition
temporary benefit, used in fistulating CD. SE- nephrotoxicity, hepatotoxicity, malignancy
Term
TNF inhibitors
Definition
adalimumab, certrolizumab, infliximab,
Term
Adalimumab
Definition
moderate to severe CD, SC injections
Term
Certolizumab
Definition
Reduce s/sx and maintain clinical response in moderate to severee CD, fistulizing CD; SC injections
Term
Infliximab
Definition
moderate to severe UC or CD, and fistulizting CD; maintains remission of Crohn's given ever 8 weeks; IV dosage form
Term
CI of Infliximab
Definition
Active infection, moderate to severe heart failure, untreated TB
Term
Infliximab AE
Definition
HA, nausea, injection site reaction, rash, fatigue
Term
Infliximab increased risk of infection
Definition
bacterial, mycobacterial, fungal
Term
Infliximab:
Definition
increased risk for hepatosplenic T-cell lymphoma
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