5-ASA Compounds – Treatment of Inflammatory Bowel Disease

by Carlo Raj, MD

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    Management We talked about Aminosalicylic acid, Topical (rectal), oral, IV corticosteroids Immunomodulators, Azathioprine, 6–Mercaptopurine Anti–TNF therapy, but you're always worried about reactivation TB. Antibiotics Levaquin, Flagyl Total Parenteral Nutrition especially for Crohn's due to malnutrition. Surgery Be very careful with Crohn's because of the delicate nature of the disease with Crohn's, that you might actually cause more harm than good. The Aminosalicylic acid, what is it? Local anti–inflammatory, what it does is inhibition of the COX pathway. More effective in colonic than ileal disease, can induce and maintain remission, usually for Ulcerative colitis. Why? Why? Ulcerative colitis only involves the colon. And so therefore when you give an enema or you give a rectal type of administration, understand that you're more effective in the colon than you would be in the ileum therefore more effective with Ulcerative colitis. Side Effects Occur in 30%. Sulfasalazine much, much, much, much so; more so than mesalamine. Nausea, rash, hair loss, hemolysis, pancreatitis, hepatitis, aplastic anemia are things that you want to keep in mind. Sulfasalazine. Corticosteroids Topical preparation, Oral preparation needed for more proximal or extensive disease switch it if it's Crohn's. IV preparation for severely ill. Useful for induction but not for maintainance. The significant side effects of long term we've talked about this quite a bit. The fact that you might be lymphopenic, the fact that you might then cause avascular necrosis of the bone resulting in destruction and fractures. Corticosteroids, of course, over a long period of time, a common cause of Iatrogenic type of Cushing's....

    About the Lecture

    The lecture 5-ASA Compounds – Treatment of Inflammatory Bowel Disease by Carlo Raj, MD is from the course Small and Large Intestine Diseases.

    Included Quiz Questions

    1. Fistulas
    2. Oral ulcers
    3. Primary sclerosing cholangitis
    4. Arthritis
    5. Uveitis
    1. Mantoux test and chest X -ray
    2. Urine analysis and Ultrasound of abdomen
    3. Colonoscopy and biopsy
    4. Bence Jones protein and skull X-ray
    5. PT/APTT and INR
    1. Pancreatic amylase
    2. Beta HCG levels
    3. Prostate-specific antigen levels
    4. Urinary stercobilin levels
    5. TSH levels

    Author of lecture 5-ASA Compounds – Treatment of Inflammatory Bowel Disease

     Carlo Raj, MD

    Carlo Raj, MD

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