RT Book, Section
A1 McQuaid, Kenneth R.
A2 Katzung, Bertram G.
SR Print(0)
ID 1148443241
T1 Drugs Used in the Treatment of Gastrointestinal Diseases
T2 Basic & Clinical Pharmacology, 14e
YR 2017
FD 2017
PB McGraw-Hill Education
PP New York, NY
SN 9781259641152
LK accesspharmacy.mhmedical.com/content.aspx?aid=1148443241
RD 2024/04/19
AB CASE  STUDYA  21-year-old  woman  comes  with  her  parents  to  discuss  therapeutic  options  for  her  Crohn’s  disease.  She  was  diagnosed  with  Crohn’s  disease  2  years  ago,  and  it  involves  her  terminal  ileum  and  proximal  colon,  as  confirmed  by  colonoscopy  and  small  bowel  radiography.  She  was  initially  treated  with  mesalamine  and  budesonide  with  good  response,  but  over  the  last  2  months,  she  has  had  a  relapse  of  her  symptoms.  She  is  experiencing  fatigue,  cramping,  abdominal  pains,  and  nonbloody  diarrhea  up  to  10  times  daily,  and  she  has  had  a  15-lb  weight  loss.She  has  no  other  significant  medical  or  surgical  history.  Her  current  medications  are  mesalamine  2.4  g/d  and  budesonide  9  mg/d.  She  appears  thin  and  tired.  Abdominal  examination  reveals  tenderness  without  guarding  in  the  right  lower  quadrant;  no  masses  are  palpable.  On  perianal  examination,  there  is  no  tenderness,  fissure,  or  fistula.  Her  laboratory  data  are  notable  for  anemia  and  elevated  C-reactive  protein.  What  are  the  options  for  immediate  control  of  her  symptoms  and  disease?  What  are  the  long-term  management  options?