How do you approach the use of immunosuppressive medications in patients with inflammatory bowel disease?

Sample interview questions: How do you approach the use of immunosuppressive medications in patients with inflammatory bowel disease?

Sample answer:

Approach to Immunosuppressive Medications in Inflammatory Bowel Disease (IBD)

Immunosuppressive medications are a mainstay of therapy for patients with moderate-to-severe inflammatory bowel disease (IBD). The choice of immunosuppressive agent depends on several factors, including disease severity, patient characteristics, and response to previous treatments.

Stepwise Approach:

1. Induction of Remission:
2. Start with a high-potency immunosuppressant, such as corticosteroids or tumor necrosis factor (TNF) inhibitors.

3. Consider combination therapy with two or more immunosuppressants for severe disease.

4. Maintenance of Remission:

5. Once remission is achieved, gradually taper immunosuppressive therapy while monitoring for disease activity.
6. Consider long-term maintenance therapy with a low-dose immunosuppressant to prevent relapse.

Choice of Immunosuppressant:

• Corticosteroids: Short-term use for induction of remission, but not recommended for long-term maintenance due to adverse effects.
• TNF Inhibitors: First-line agents for moderate-to-severe Crohn’s disease and ulcerative colitis, highly effective but expensive.
• Azathioprine and Mercaptopurine: Thiopurines with moderate efficacy, commonly used in… Read full answer

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