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IBD Treatmet Plan of UC - Coggle Diagram

- - - - Mild-Moderate
        
        Topical mesalamine is superior to both topical corticosteroids and oral aminosalicylates in patients with distal disease.
        Enemas are appropriate for patients with left-sided disease because the medication will reach the splenic flexure.
        Suppositories suitablr for proctitis.
        Combination of oral and topical mesalamine preparations is more effective.
        Combination is more effective in extensive or left-sided disease.
        DOSE: oral mesalamine dose target dose should be 2 to 3 g/day (3 g only if no response).
        Induction of
        DOSE: oral mesalamine dose target dose should be 2 to 3 g/day (3 g only if no response).
        Induction of
      - Topical CS:
        limited role. reserved for patients who are intolerant or
        unresponsive to topical mesalamine.
        The oral budesonide MMX formulation, only for pt unresponsive to optimized topical.
        Oral prednisone is also an option; however, its
        effects are systemic.
        Patients requiring systemic corticosteroids should have them tapered over 4 to 12 weeks
      - Moderate-Severe
        
        Oral budesonide MMX (4 mod-sev active extensive UC.
        prednisone 40 to 60 mg/day (4 weeks) recommended for any extent
        
        Biological Agents (Cornerstone)
        Choice depends on depends on previous exposure to biologic agents.
        Naive pts. infliximab or vedolizumab + immunomodulator (eg, azathioprine) is recommended.
        For pt previously Tx with biological, give ustekinumab or tofacitinib
    - - Acute severe UC: (ASUC) , Hospitalization required, methylprednisolone 40 to 60 mg IV per day. IF no respond after 3-4 days, give infliximab or cyclosporin continuous IV infusion of 2–4 mg/kg/day.