6441 Gastrointestinal Pharm|Inflammatory Bowel Disease: Ulcerative
Colitis vs Crohn’s Disease, Skip Lesions, Rectal Involvement, 5-ASA Therapy:
Mesalamine, Sulfasalazine, Balsalazide, Olsalazine, Prodrugs and Targeted
Delivery, Enemas vs Suppositories, Oral pH and Bacterial Release
Formulations, Acid Secretion: Parietal Cells, H+/K+ ATPase, Intrinsic Factor,
Oral Antacids (Al, Ca, Mg), Alginate Barrier, H2 Receptor Antagonists:
Cimetidine, Famotidine, Nizatidine, Ranitidine, Proton Pump Inhibitors:
Omeprazole, Lansoprazole, Esomeprazole, Dexlansoprazole, Drug
Interactions, Long-term Safety, Vomiting Pathways: VC, CTZ, Vestibular, GI,
Brain Cortex, Antiemetics: Antihistaminic-Anticholinergic
(Diphenhydramine, Meclizine, Scopolamine), Dopamine Antagonists
(Metoclopramide, Phenothiazines, Butyrophenones), 5-HT3 RA
(Ondansetron, Granisetron), NK1 RA (Aprepitant), Benzodiazepines,
Corticosteroids, Laxatives: Bulk-forming (Psyllium, Polycarbophil), Osmotic
(Lactulose, PEG 3350, Sorbitol, Mg Hydroxide) Exam Questions Verified and
Provided with Complete A+ Graded Rationales Latest Updated 2026
Ulcerative colitis
ulcers move from rectum back
Crohn's disease
Skip lesions - anywhere on the GI tract
Mesalamine
Active drug of 5-ASA
Brand names: Apriso, Asacol HD, Canasa, Delzicol, Lialda, Pentasa, Rowasa
Prodrugs converted to 5-ASA
Have to cleeve 5-ASA to work
, Balsalazide
Colazal
Inert carrier molecule azo bound to 5-ASA
Olsalazine
Dipentum
Two 5-ASA moieties linked by an azo bond
Sulfazalazine
Azulfidine
Sulfapyridine linked to 5-ASA
Causes a lot of GI intolerance, if occurs reduce dose by 50%
Avoid in patients with a sulfa allergy
Can cause reversible male infertility due to reduction in sperm
Inhibits folate absorption warranting women attempting to get pregnant to take 2mg of folic acid a day
5 ASA MOA
Localized or targeted anti-inflammatory within the colonic mucosa of the lumen of the GI tract
Module the local release of pro-inflammatory mediators derived from arachidonic acid such as
leukotrienes
May also function to scavenge free radicals
Some agents have carrier molecules to facilitate specific actions at a particular location in the intestinal
lumen (e.g. drug release only within large intestine)
This is in part why 5-ASA products tend to be more effective for UC vs Crohns
Colitis vs Crohn’s Disease, Skip Lesions, Rectal Involvement, 5-ASA Therapy:
Mesalamine, Sulfasalazine, Balsalazide, Olsalazine, Prodrugs and Targeted
Delivery, Enemas vs Suppositories, Oral pH and Bacterial Release
Formulations, Acid Secretion: Parietal Cells, H+/K+ ATPase, Intrinsic Factor,
Oral Antacids (Al, Ca, Mg), Alginate Barrier, H2 Receptor Antagonists:
Cimetidine, Famotidine, Nizatidine, Ranitidine, Proton Pump Inhibitors:
Omeprazole, Lansoprazole, Esomeprazole, Dexlansoprazole, Drug
Interactions, Long-term Safety, Vomiting Pathways: VC, CTZ, Vestibular, GI,
Brain Cortex, Antiemetics: Antihistaminic-Anticholinergic
(Diphenhydramine, Meclizine, Scopolamine), Dopamine Antagonists
(Metoclopramide, Phenothiazines, Butyrophenones), 5-HT3 RA
(Ondansetron, Granisetron), NK1 RA (Aprepitant), Benzodiazepines,
Corticosteroids, Laxatives: Bulk-forming (Psyllium, Polycarbophil), Osmotic
(Lactulose, PEG 3350, Sorbitol, Mg Hydroxide) Exam Questions Verified and
Provided with Complete A+ Graded Rationales Latest Updated 2026
Ulcerative colitis
ulcers move from rectum back
Crohn's disease
Skip lesions - anywhere on the GI tract
Mesalamine
Active drug of 5-ASA
Brand names: Apriso, Asacol HD, Canasa, Delzicol, Lialda, Pentasa, Rowasa
Prodrugs converted to 5-ASA
Have to cleeve 5-ASA to work
, Balsalazide
Colazal
Inert carrier molecule azo bound to 5-ASA
Olsalazine
Dipentum
Two 5-ASA moieties linked by an azo bond
Sulfazalazine
Azulfidine
Sulfapyridine linked to 5-ASA
Causes a lot of GI intolerance, if occurs reduce dose by 50%
Avoid in patients with a sulfa allergy
Can cause reversible male infertility due to reduction in sperm
Inhibits folate absorption warranting women attempting to get pregnant to take 2mg of folic acid a day
5 ASA MOA
Localized or targeted anti-inflammatory within the colonic mucosa of the lumen of the GI tract
Module the local release of pro-inflammatory mediators derived from arachidonic acid such as
leukotrienes
May also function to scavenge free radicals
Some agents have carrier molecules to facilitate specific actions at a particular location in the intestinal
lumen (e.g. drug release only within large intestine)
This is in part why 5-ASA products tend to be more effective for UC vs Crohns
