Medical Pharmacology: Gastrointestinal Pharmacology Practice Questions
Choose the correct answer for each question.
First-line therapy typically involves 5-aminosalicylic acid (5-ASA) administration:
Maintenance of remission in Crohn's disease
Management of mild-to-moderate presentations of ulcerative colitis.
Both
Neither
The prototypical agent in the mesalamine-based therapy (5-ASA, (Canasa, Apriso and others)) of inflammatory bowel disease (IBD) is sulfasalazine (Canasa, Apriso and others)
True
False
Sulfasalazine (Azulfidine):
This agent is an oral prodrug
Sulfasalazine is 5-aminosalicyclic acid linked to sulfapyridine (azo bond).
Both
Neither
Concerning sulfasalazine:
The "azo" linkage of the drug prevents stomach and small intestinal drug absorption.
5-aminosalicyclic acid (5-ASA, mesalamine) is made available by the action of bacteria found in the: expressing azoreductase, catalyzing the cleavage reaction.
Both
Neither
Concerning 5-ASAmechanism of action in inflammatory bowel disease:
The major mechanism involves blockade of cyclooxygenase (COX), as expected since 5-ASA is a salicylate.
Traditional NSAIDs tend to worsen IBD and are contraindicated in this condition.
Both
Neither
The active drug form for sulfasalazine, basalazide (Colazal, Giazo), olsalazine (Dipentum) is mesalamine (5-ASA).
True
False
The advantage of second-generation 5-ASA drugs is in the elimination of adverse effects of sulfapyridine.
True
False
Second-generation 5-ASA agents:
Replace sulfapyridine with another 5-ASAin the case of olsalazine..
Replace sulfapyridine with an inert agent (Balsalazide)
Both
Neither
Additional method(s) to circumvent adverse effects of sulfapyridine:
Administer mesalamine using a delayed release formulation.
Administer mesalamine directly with a pH-sensitive coating.
