Critical Thinking

AbstractThe drugs are prescribed and not sold over

AbstractThe aim of this presentation is to give an overview of the drug mesalazine in the treatment of IBD. Mesalazine is an anti-inflammatory drug which is added as the active pharmaceutical ingredient (API) in several different formulations. There are different drugs which release the API at different rates. Most are pH dependent and this allows the drug to be topically applied to the most affected parts of the gastrointestinal tract, therefore drugs are prescribed and not sold over the counter. Irritable Bowl Disease has two main condition; ulcerative colitis and Chron’s disease. Mesalazine and other amino-salicylate drugs are used to treat IBD by reducing inflammation and maintaining remission. Many studies to show the efficacy and action mechanism of mesalazine are comparisons with the other drugs used to treat IBD such as sulphasalazine, as opposed to non-comparative studies. This would suggest that more research on the drug is needed. There is also lack of evidence to prove a true drug action mechanism. The daily dosage for adults has been well studied, but there is a lack of study into pregnant women and children. ReferencesAmitabh Prakash, Anthony Markham (1999) – Oral Delayed-Release Mesalazine, Drugs, 57(3): 383-408.Böhm S, Kruis W (2014) – Long-term efficacy and safety of once-daily mesalazine granules for the treatment of active ulcerative colitis, Clinical and Experimental Gastroenterology, 7: 369-383Brogden RN1, Sorkin EM (1989) – Mesalazine. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic potential in chronic inflammatory bowel disease, Drugs, 38(4): 500-23.Carmen Cuffari, David Pierce, Bartosz Korczowski, Krzysztof Fyderek, Heather Van Heusen, Stuart Hossack, Hong Wan, Alena YZ Edwards, and Patrick Martin (2016) – Randomized clinical trial: pharmacokinetics and safety of multimatrix mesalamine for treatment of pediatric ulcerative colitis, Drug Design, Development and Therapy, 10: 593–607Chris Probert (2013) – Steroids and 5-aminosalicylic acids in moderate ulcerative colitis: addressing the dilemma, Therapeutic Advances in Gastreonemy, 6(1): 33-38Diav-Citrin O, Park YH, Veerasuntharam G (1998) – The safety of mesalamine in human pregnancy: a prospective controlled cohort study. Exposure to mesalamine during pregnancy increased preterm deliveries (but not birth defects) and decreased birth weight, Gastroenterology, 114: 23–8. FDA (2018), First time generic drugs 2017, fda.gov/drugs/DevelopmentApprovalProcess/HowDrugsareDevelopedandApproved/DrugandBiologicApprovalReports/ANDAGenericDrugApprovalsKindersley Dorling (2012) BMA Concise Guide to Medicine and Drugs, pg. 300-301.Martine De Vos (2000) Clinical Pharmacokinetics of Slow Release Mesalazine, Clinical Pharmacokinetics, 39(2): 85-97.Sarah MacDonald (2002) Aspirin to be Banned in Under 16 Year Olds, BMJ, 325(7371): 988.Srini Tenjarla (2015) – Dissolution of Commercially Available Mesalamine Formulations at Various pH Levels, Drugs in R, 15(2): 211-215W. J. SANDBORN & S. B. HANAUER (2002) – Systematic review: the pharmacokinetic profiles of oral mesalazine formulations and mesalazine pro-drugs used in the management of ulcerative colitis, Alimentary Pharmacology & Therapeutics, 17(1): 29-42Yasuo Suzuki, Mitsuo Iida, Hiroaki Ito, Isamu Saida and Toshifumi Hibicor (2016) – Efficacy and safety of two pH-dependent-release mesalamine doses in moderately active ulcerative colitis: a multicentre, randomised, double-blind, parallel-group study, Intestinal Research, 14(1): 50-59Yoshinori Arai, Seiji Arihiro, Daisuke Ide, Isao Odagi,a Munenori Itagaki, Nobuhiko Komoike, Yutaka Nakao, Kazuki Takakura, Masayuki Saruta, Mika Matsuoka, Tomohiro Kato, and Hisao Tajiria (2011) – Acute Pancreatitis due to pH-Dependent Mesalazine That Occurred in the Course of Ulcerative Colitis Case Reports in Gastroentrology, 5: 610-616.

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