Navigating Medications
While we will not go into detail about the specific details of each type of medication, it's important to know some of the main groups of medications. Generally, medications are meant to suppress inflammation or any damage present within your gastrointestinal tract. Biologics are usually given intravenously (or within a vein) or subcutaneously (or just under the skin). With the exception of 6-MP which is given intravenously, immunomodulators usually come in the form of oral pills. Aminosalicyates are also given orally. Nutritional support comes in the form of oral dietary supplements and intravenous or tube related methods to deliver nutrients, minerals, and/or vitamins. Below we list some important timings of medications.
Keeping Track of Medications
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One of the biggest challenges with managing lifestyle as someone with IBD is to keep track of medications and take medications on time, a concept we also call medication adherence. This makes sense as the lack of medication adherence is 50% or more in patients with chronic illnesses across the world. Also, as people with IBD, we may have multiple medications we have to take at different times which can be really hard to keep a track of.
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There has been a rise in mobile phone apps to help with tracking medications for IBD.
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In the Management Section, we provide a section on various smartphone apps that exist to help with reminders in partnership with the Children's Mercy Hospital Team at Kansas City.
PAC Tips
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Google Calendar: Available on a computer, Android, and iOS, Google Calendar has been a popular method of keeping track of different events and now we can also add reminders. One can fill in what time of the day and how often the medication needs to be taken.
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Medisafe Medication Management: Similar to Google Calendar, Medisafe Medication Management is a free smartphone-based application that lets you add medications with frequency, timings, and even allows you to link pharmacy refills. Clearly it’s more visual and one of the cool features it has is its medication shaking notification sound as a reminder.
Resources
Sources
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Improve Care Now Medications Toolkit team
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http://www.crohnscolitisfoundation.org/resources/immunomodulators.html
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http://www.crohnscolitisfoundation.org/resources/aminosalicylates.html
Types of Medications for IBD
Biologics
Including:
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Remicade
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Humira
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Stelara
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Entyvio
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Cimzia
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Simponi
Corticosteroids
Including:
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Prednisone
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Budesonide
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Cortenama
Aminosalicylates
Including:
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Sulfasalazin: Azulfidine, Sulfazine
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Balsalazide: Colazal, Giazo
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Mesalamine: Pentasa, Delzicol, Rowasa, Apriso, Canasa, Asacol, Lialda
Nutritional Support
Including:
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TPN and Lipids
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NG feedings
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G-tube
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Supplements
Immunomodulators
Including:
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Methotrexate: Otrexup, Rasuvo, Rheumatrex, Trexall
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6MP: Purinthenol, Purixan
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Azathioprine: Imuran, Azasan
Challenges
Obstacles to Medical Adherence
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Forgetfulness
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Lack of faith that the medication is helping
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Inconvenient application/administration
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Insurance/financial constraints
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Cultural stigma
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Feeling helpless with IBD treatment