DƯỢC LÍ Goodman & Gilman's The Pharmacological Basis of Therapeutics 12th, 2010

1352
SECTION VI
DRUGS AFFECTING GASTROINTESTINAL FUNCTION
Table 47–1
Medications Commonly Used to Treat Inflammatory Bowel Disease
CROHN’S DISEASE
ACTIVE DISEASE MAINTENANCE ACTIVE DISEASE
ULCERATIVE COLITIS
Mild- Moderate- Medical Surgical Distal Mild- Moderate-
CLASS/Drug Moderate Severe Fistula Remission Remission Colitis Moderate Severe Maintenance
Mesalamine
Enema + a – – – – + + a,b – +
Oral + – – +/– + c + + – +
Antibiotics
(metronidazole + + + ? + c – – – + c
ciprofloxacin,
others)
Corticosteroids
Enema, foam, + a – – – + + b – – –
suppository
Oral + + – – – + + + –
Intravenous – + – – – + d – + –
Immunomodulators
6-MP/AZA – + + + + c + d – + d + d
Methotrexate – ? ? ? ? – – – –
Cyclosporine – + d + d – – + d – + d –
Biological response
modifiers
Infliximab + d + + + c ? + – + ?
Adalimumab + + + + ? ? ? ? ?
Certolizumab pegol + + ? + ? ? ? + ?
Natalizumab – + ? + ? ? ? ? ?
a
Distal colonic disease only.
b
For adjunctive therapy.
c
Some data to support use; remains controversial.
d
Selected patients.
ABBREVIATIONS: 6-MP, 6-mercaptopurine; AZA, azathioprine. (From Sands BE. Therapy of inflammatory bowel disease. Gastroenterology. 2000;118(2 Suppl 1): S68-S82. Table 1, Pg S71.
With permission from Elsevier. Copyright © Elsevier.)