Inflammatory bowel disease mesalamine

Drugs that contain 5-aminosalicylic acid (5-ASA) have been used successfully for decades in the treatment of inflammatory bowel diseases (Figure 62-8). 5-ASA differs from salicylic acid only by the addition of an amino group at the 5 (meta) position. Aminosalicylates are believed to work topically (not systemically) in areas of diseased gastrointestinal mucosa. Up to 80% of unformulated, aqueous 5-ASA is absorbed from the small intestine and does not reach the distal small bowel or colon in appreciable quantities. To overcome the rapid absorption of 5-ASA from the proximal small intestine, a number of formulations have been designed to deliver 5-ASA to various distal segments of the small bowel or the colon. These include sulfasalazine, olsalazine, balsalazide, and various forms of mesalamine. 

Goldstein F, DiMarino AJ Jr. Diarrhea as a side effect of mesalamine treatment for inflammatory bowel disease. J Clin Gastroenterol 2000 31(l) 60-2. 

Margetts PJ, Churchill DN, Alexopoulou I. Interstitial nephritis in patients with inflammatory bowel disease treated with mesalamine. J Clin Gastroenterol 200I 32 (2) I76-8. 

TABLE 34—5. Mesalamine Derivatives for Treatment of Inflammatory Bowel Disease... 

Mesalamine (5-aminosalicylic acid asacol, others) is a salicylate that is used for its local effects in the treatment of inflammatory bowel disease (see Chapter 38). It currently is available as a suppository and rectal suspension enema (rowasa) for treatment of mild-to-moderate proctosigmoiditis Cl rectal suppository (canasa, others) for the treatment of distal ulcerative colitis, proctosigmoiditis, or proctitis. Oral formulations and controlled-release capsule that deliver drug to the lower intestine are efficacious in treatment of inflammatory bowel disease, in particular ulcerative colitis. Sulfasalazine (salicylazosulfapyridine azulfidine) contains mesalamine linked covalently to sulfapyridine (see Chapter 38) it is absorbed poorly after oral administration, but it is cleaved to its active components by bacteria in the colon. The drug is of benefit in the treatment of inflammatory bowel disease, principally because of the local actions of mesalamine. 

Bisrnudi subsalicylate is used in combination widi odier dru to treat gastric and duodenal ulcers caused by H. pylori bacteria Mesalamine is used in the treatment of chronic inflammatory bowel disease Misoprostol is used to prevent gastric ulcers in those taking aspirin or nonsteroidal anti-inflammatory dru in high doses for a prolonged time Olsalazine is used in the treatment of ulcerative colitis in those allergic to sulfasalazine. Sulfasalazine is used in the treatment of Crohn s disease and ulcerative colitis. Sucralfate is used in the treatment of duodenal ulcer. 

The client diagnosed with inflammatory bowel disease taking mesalamine (Asacol), an aspirin product, has complaints of nausea, vomiting, and diarrhea. Which action should the clinic nurse take ... 

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