CORRECTION:
Drugs used in inflammatory bowel disease inflammatory bowel disease is an umbrella term used to describe autoimmune disorders that involve chronic inflammation of the gi t now remember these two keywords autoimmune and inflammation the two important diseases that are categorized under the term inflammatory bowel disease are ulcerative colitis and crohn’s disease the
Symptoms of both of them are basically the same and it’s very difficult to differentiate between both of them unless a colonoscopy is done the ulcerative colitis is a long-lasting inflammation and sores or ulcers in the inner lining of the colon while crohn’s disease will occur in all the layers of the bowel walls ulcerative colitis as it is indicated in the name
It is only limited to the colon while crohn’s disease can occur anywhere from the mouth to the anus ulcerative colitis is continuous inflammation while in crohn’s disease there are healthy parts of the intestine mixed with the inflamed parts now the symptoms of both of them are about the same and as i said you can’t differentiate the symptoms are diarrhea bleeding
Abdominal discomfort anemia and weight loss the management of inflammatory bowel disease include three approaches one is to suppress the inflammation of the cart second is to prevent any infection and thirdly to decrease the immune response because it is an autoimmune disease to suppress the inflammation we use a manual salicylates and also glucocorticoids to treat
The infection we use antibiotics of course and to suppress the immunity of the patient we use immunosuppressants and biological dmards the same ones which were used in rheumatoid arthritis because that was an autoimmune disease as well now in a minor salicylates the active molecule is basically masala mine or missile azim or 5 a minor salicylic acid now salicylic
Acid if you remember is the same thing that was basically aspirin acetylsalicylic acid that was but it’s chief action was to inhibit inflammatory mediators release such as interleukin 1 tnf alpha leukotrienes etc now there are four drugs that we can use to deliver this active molecule that is 5a sa to the colon one is sulfasalazine second is miss ella mine which is
The active molecule itself also lezyne and balsille azide sulfasalazine also lezyne and bel silicide are for drugs sulfasalazine is basically sulfur paradine and 5a sa masala mine is five sa all salle’s een is two molecules of 5a sa linked by an as well engage and balsille azide r is 5a s a and another metabolite now sulfasalazine when colonic bacteria act on it it
Is converted into sulfur paradeen and five si 5 si will do its job as anti-inflammatory but the sulfur paradine part of the drug will cause a severe side effects such as skin rash fever hepatitis pancreatitis pneumonitis etc now one way to remember the side-effects is that the one metabolite of sulfasalazine that is 5a si is anti-inflammatory while sulfur paradeen
Is pro-inflammatory methylamine is given in delayed release capsules or ph dependent tablets so that its active form is released in the colon and not absorbed in upper gi t all salasi n– is converted by a colonic bacteria to its active form and so is belzoni side the other anti-inflammatory agents that are we are using are glucocorticoids of course they are used
For the short term treatment chief drugs are prednisolone and hydrocortisone if their use is prolonged they can lead to adrenal suppression and other severe side effects such as osteoporosis peptic ulcers infections and hyperglycemia now why we use antibiotics because one theory regarding ibs is that you can get ibs by abnormal balance of colonic bacteria we give
Antibiotics to decrease the harmful bacteria to protect the gut wall from infection and to decrease the inflammatory response to infection the main antibiotics used can be metronidazole kara through clarithromycin and ciprofloxacin now the last approach to treatment of ibs is to decrease the immune response we use two types of drugs that is immunosuppressants
And biological dmards the chief immunosuppressants use our azathioprine six mill captor purine methotrexate and cyclosporine now azathioprine is basically a prodrug of six mill captor purine which is a drug which blocks purine metabolism and dna synthesis so it basically inhibits formation of lymphocytes and thus decreased antibody production or t cell immunity
Methotrexate is actually d hf reductase inhibitor dihydrofolate reductase inhibitor and it will suppress the bone marrow and decreased antibody formation will be their cyclosporine is actually interleukin 2 inhibitor and that will inhibit the t-cell activation the biological dmards act by acting as tnf alpha antagonists mainly omalu map can be used but their use
Is restricted due to the increased cost and risk of infections by suppressing the immunity that’s all about ibs
Transcribed from video
Pharmacology-Inflammatory Bowel Disease (IBS)-GIT- MADE EASY! By Med Made Sirius-ly easy!