Inflammatory Bowel Disease
IBD
Aminosalicylates - for mild symptoms (colorectal cancer)
Corticosteroids - for moderate symptoms to (severe relapses)
Thiopurines - for active and chronic symptoms + Steroid sparing
Methotrexate - for active and chronic symptoms +
Cyclosporin - for active and chronic symptoms refractory to +Steroid sparing +Bridging therapy
corticorsteroids- (significant side effects)
lnfliximab - antibody infusion Fistulizing Crohn's disease (CD) +Severe active CD refractory/intolerant of steroids or immunosuppression
Sulfasalazine
MesaLazine
BaLsalazide
OLsalazine
5-aminosalslate + sulfapyridine
(5-ASA)
(prodrug of 5-ASA)
(5-ASA dimer cleaves in colon)
Prednisolone
"Inhibition of inflammation (IL transcription, arachidonic acid metabolism, lymphocyte apoptosis)."
Side effects معروفات
Azathioprine, mercaptopurine
Inhibit ribonucleotide synthesis
اعراض Leucopaenia (myelotoxic)
"Inhibits dihydrofolate reductase. + inhibits cytokine and eicosanoid synthesis
Relapsing or active CD refractory or intolerant to AZA or thiopurine
Inhibitor of calcineurin, preventing clonal expansion of T cell subset
A.E
Tremor, paraesthesiae, malaise, headache, abnormal LFT Gingival hyperplasia, hirsutism
Major: renal impairment, infections, neurotoxicity
Anti TNF-α monoclonal antibody
Infusion reactions • Sepsis
• Reactivation of Tb, increased risk of Tb