Colitis drugs

Anonymous. Asacol mesalazine for ulcerative colitis. Drug Ther Bull 1986 24(10) 38. ... 

Aminosalicylates contain a 5-aminosalicylic acid component and these drugs are used primarily to treat active Crohn s disease, and to induce and maintain remission of the symptoms of ulcerative colitis. Drugs in this group include... 

Ardizzone S, Porro GB. Comparative tolerability of therapies for ulcerative colitis. Drug Saf 2002 25 561-582. 

Yang LP, McCormack PL. MMX Mesalazine a review of its use in the management of mild to moderate ulcerative colitis. Drugs 2011 71 221-35. 

As with all drugs, the specific side effects of the quinolones must be considered when they are chosen for treatment of bacterial infections [5]. Reactions of the gastrointestinal tract and the central neivous system are the most often observed adverse effects during therapy with quinolones. It should be underlined, however, that compared with many other antimicrobials, diarrhea is less frequently observed during quinolone treatment. Antibiotic-associated colitis has been observed rarely during quinolone therapy. Similarly, hypersensitivity reactions, as observed during therapy with penicillins and other (3-lactams, is less frequently caused by quinolones. Some other risks of quinolone therapy have been defined and must be considered if a drug from this class is chosen for treatment of bacterial infections. 

Promoting an Optimal Response to Therapy The patient receiving a sulfonamide drug almost always lias an active infection. Some patients may be receiving one of Hiese drugs to prevent an infection (prophylaxis) or as part of Hie management of a disease such as ulcerative colitis. 

Pseudomembranous colitis may occur after 4 to 9 days of treatment with penicillin or as long as 6 weeks after the drug is discontinued. 

DIARRHEA Diarrhea may be an indication of a super-infection of the gastrointestinal tract or pseudomembranous colitis. The nurse inspects all stools and notifies the primary health care provider if diarrhea occurs because it may be necessary to stop the drug. If diarrhea does occur and there appears to be blood and mucus in the stool, it is important to save a sample of the stool and test for occult blood using a test such as Hemoccult. If the stool tests positive for blood, the nurse saves the sample for possible further laboratory analysis. 

The nurse inspects each bowel movement and immediately reports to the primary health care provider the occurrence of diarrhea or loose stools containing blood and mucus because it may be necessary to discontinue the drug use and institute treatment for diarrhea, a superinfection, or pseudomembranous colitis. 

Bacterial or fungal superinfections and pseudomembranous colitis (see Chap. 7) may occur with the use of both of these drugs. The administration of any drug may result in a hypersensitivity reaction, which can... 

Vancomycin (Vancocin) acts against susceptible gram-positive bacteria by inhibiting bacterial cell wall synthesis and increasing cell wall permeability. This drug is used in the treatment of serious gram-positive infections that do not respond to treatment with other anti-infectives. It also may be used in treating anti-infective-associated pseudomembranous colitis caused by Clostridium difficile. 

The peripherally acting antiadrenergic drugs are contraindicated in patients with a hypersensitivity to any of the drugs. Reserpine is contraindicated in patients who have an active peptic ulcer or ulcerative colitis and in... 

These drugs are contraindicated in patients whose diarrhea is associated witii organisms that can harm the intestinal mucosa (Escherichia coli, Salmonella, Shigella) and in patients with pseudomembranous colitis, abdominal pain of unknown origin, and obstructive jaundice The antidiarrheal drugs are contraindicated in children younger than 2 years. 

Employed as the hydrochloride and administered by dilute intravenous injection, vancomycin is indicated in potentially life-threatening infections that cannot be treated with other effective, less toxic, antibiotics. Oral vancomycin is the drug of choice in the treatment of antibiotic-induced pseudomembranous colitis associated with the administration of antibiotics such as clindamycin and lincomycin (section 9.3). 

Create a patient-specific drug treatment plan based on symptoms, severity, and location of ulcerative colitis or Crohn s disease. 

Surgical intervention is a potential treatment option in patients with complications such as fistulae or abscesses, or in patients with medically refractory disease. Ulcerative colitis is curable with performance of a total colectomy. Patients with UC may opt to have a colectomy to reduce the chance of developing colorectal cancer. Patients with CD may have affected areas of intestine resected. Unfortunately, CD may recur following surgical resection. Repeated surgeries may lead to significant malabsorption of nutrients and drugs consistent with development of short-bowel syndrome. 

Ischemic colitis has been observed in some patients taking tegaserod. The drug should be discontinued promptly if rectal bleeding, bloody diarrhea, or worsening abdominal pain occurs. 

Although theoretically safe, poorly absorbed antimicrobials could become absorbable in the presence of mucosal inflammatory or ulcerative changes [100], like those occurring in IBD or when invasive bacteria colonize the intestine. To verify whether the presence of intestinal lesions would affect rifaximin absorption, the drug was given to rats with experimentally induced colitis [101]. The indomethacin-induced enteropathy did not affect intestinal absorption of rifaximin. However, under the same experimental conditions, systemic bioavailability of neomycin did increase [101]. 

A randomized open trial, performed in patients with C. difficile pseudomembranous colitis, compared rifaximin (200 mg 3 times daily) to vancomycin (500 mg 2 times daily) and found the two drugs similarly effective [141]. The clearance of bacterial toxins was, however, more rapid with vancomycin. Further large double-blind clinical studies are needed to better define the role of rifaximin in the treatment of C. difficile infection. 

The answers are 484-k 485-j. (tlardman, pp 1061-1062, 1682-1685.) Sulfonamides can cause acute hemolytic anemia. In some patients it mayr be related to a sensitization phenomenon, and in other patients the hemolysis is due to a glucose-6-phosphate dehydrogenase deficiency Sulfamethoxazole alone or in combination with trimethoprim is used to treat UTls. The sulfonamide sulfasalazine is employed in the treatment of ulcerative colitis. Daps one, a drug that is used in the treatment of leprosy, and primaquine, an anti mala rial agent, can produce hemolysis, particularly in patients with a glucose-6-phosphate dehydrogenase deficiency. 

The first line of drug therapy for the patient with mild to moderate colitis is oral sulfasalazine or an oral mesalamine derivative, or topical mesalamine or steroids for distal disease (Fig. 26-1). 

A four-electron reduction of the azo group leads to the cleavage of the molecule and the production of two amines (Fig. 5.10). There are few drugs that contain an azo bond but a good example is sulfasalazine, which is reductively cleaved to 4-aminosalicylic acid and sulfapyridine (18). This reduction is mediated by anaerobic bacteria in the intestine, and it leads to the formation of two agents that are pharmacologically active in the treatment of ulcerative colitis. 

In order to look at the probable duration of treatment with topical agents for colonic drug delivery, we have conducted studies with normal subjects and patients with left-sided colitis. The subjects and patients were dosed daily with indium-Ill-labeled amberlite resin and imaged throughout the day. On the fourth, the division of activity in the colon was 67% in the proximal half and 33% in the distal half day for the control subjects, whereas for the patients with colitis the distribution was 90 10. These data emphasize the problem of treating left-sided colitis effectively during active periods of disease. 

Regulatory bodies such as the Food and Drug Administration (FDA) in the United States require the identification of all impurities above the 0.1% level in formulated pharmaceuticals. Once identified, the structure of the impurity is typically confirmed through synthesis to provide absolute structure identification and for use as standards in subsequent quality assurance analyses. Together, LC-MS and LC-NMR play important roles in stability testing. For example, parallel analysis by LC-NMR and LC-MS was used for the rapid structure elucidation of an unknown impurity in 5-aminosalicylic acid, which is marketed for the treatment of acute ulcerative colitis and Chron s disease [57]. In another study, Fukutsu et al. [58] used a combination... 

---