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Abdominal Pain or Colitis Case
- 1. AbdominalPain or Colitis Submitted By : Abu Bakr Ansari Pharm. D 5th Year Roll No. 1601096001 Enroll No. 1600100627 Submitted To : Dr. Mohd Ajmal Sir Assistant Professor Integral University, Lucknow Faculty of Pharmacy
- 2. Case Study Mr G is newly diagnosed with mild ulcerative colitis. His abdominal X-ray suggests predominantly disease of the rectum and sigmoid colon. His past medical history includes joint stiffness due to rheumatoid arthritis. He presents at the pharmacy with a prescription for sulphasalazine tablets and Predfoam® one at night.
- 3. Questions ? 1. What advice would you give Mr G about the administration of Predfoam® enemas? 2. What are the side effects associated with the use of topical steroids? Mr G expresses concerns to the primary care doctor about the possibility of sulphasalazine impairing fertility as he and his wife hope to start a family. The primary care doctor decides to switch Mr G to mesalazine tablets, 800mg taken three times a day. 3. Mesalazine 400mg tablets are available in several different brands. Does it matter which brand is supplied?
- 4. Answers 1. Rectal therapy is appropriate for mild left-sided disease. Enemas are best administered just before bedtime when the supine position allows longer retention times. Predfoam® comes in an aerosol can and the drug is delivered by attaching some plastic rectal tubes to the canister. A new tube is used for each dose. Patients with rheumatoid arthritis may have difficulty in using enemas and this may affect adherence and treatment success.The aerosol canister is flammable and care should be taken. 2. Prednisolone sodium metasulphobenzoate (Predfoam®) is poorly absorbed and the systemic side effects are minimal.
- 5. 3. Once initiated, patients should remain on the same brand of mesalazine as different brands have different release profiles. Relapse of disease can occur if patients are inadvertently switched to another brand. Prescribers are encouraged to prescribe by brand and not by generic name. 4. Mesalazine does not cause problems with fertility, only sulfasalazine is associated with infertility and this only affects men. Sulfasalazine affects sperm but is reversible on stopping treatment.
- 6. THANK YOU