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поздравления с днем рождения в частушках от мужчины, Causes of Crohn's Disease Flare-Ups and Managing Symptoms, Crohn’s flare: Symptoms, when to go to the hospital, and more, Crohn's Disease: Diagnosis and Management - AAFP, Crohn's disease - Symptoms and causes - Mayo Clinic, Managing Flares - Crohn's & Colitis Foundation, , .
DrugDosageAdverse effectsFDA boxed warningMonitoringCostCorticosteroidsPrednisone40 to 60 mg by mouth dailyHypertension, fluid retention, weight gain, hypernatremia, elevated blood glucose, osteoporosis, mood disorder, increased risk of infection, narrow angle glaucomaNoneBlood pressure, electrolyte panel, blood glucose level, mental status, ophthalmic examination (with prolonged therapy), dual energy x-ray absorptiometry, signs and symptoms of hyperadrenocorticism$15Budesonide (Entocort EC)9 mg by mouth every morning for up to 8 weeksDiarrhea, nausea, arthralgias, headache, respiratory tract infection, sinusitisNoneSigns and symptoms of hyperadrenocorticism and adrenal suppression with long-term therapy$600 ($2,100)ImmunomodulatorsAzathioprine (Imuran)50 mg by mouth daily (maximum: 2.5 mg per kg per day)Gastritis, nausea, vomiting, lymphoma, feverMay cause pancreatitis, leukopenia, anemia, thrombocytopeniaChronic immunosuppression increases risk of neoplasiaCreatinine level at baseline Complete blood count weekly for 1 month, then every 2 weeks for 2 months, then monthly and when dosage changes Liver enzyme tests TPMT to guide dosing and TDM in select cases$20 ($200)6-mercaptopurine50 mg by mouth daily (maximum: 1.5 mg per kg per day)Myelosuppression, hepatic toxicity, immunosuppression, hepatic encephalopathy, pancreatitis, rash, hyperpigmentation, lymphoma, feverNoneCreatinine level at baseline Complete blood count with differential weekly during induction Liver enzyme tests weekly during induction TPMT and TDM in select cases$45Methotrexate25 mg subcutaneously or intramuscularly per weekAlopecia, photosensitivity, rash, diarrhea, anorexia, nausea, vomiting, stomatitis, leukopenia, pneumonitisMay also cause hyperuricemia, gastrointestinal hemorrhage, myelosuppression, hepatotoxicity, lung fibrosis, renal failureFetal death and congenital abnormalities (not recommended for use in women of childbearing age), hepatotoxicityFibrosis and cirrhosis with prolonged useMalignant lymphoma may occurChest radiography at baselineComplete blood count with differential and platelet count at baseline, then monthlyBlood urea nitrogen measurement, creatinine level, and liver enzyme tests at baseline, then every 4 to 8 weeks$20BiologicsAnti-TNF agents Adalimumab (Humira)160 mg subcutaneously once at week 0, then 80 mg once at week 2, then 40 mg every 2 weeksInjection site reactions (e.g., erythema, itching, hemorrhage, pain, swelling), infection, tuberculosis, malignancies (e.g., lymphoma), autoantibodies/lupus-like syndromeActive tuberculosis, reactivation of latent tuberculosis, invasive fungal infections (may include histoplasmosis, coccidioidomycosis, candidiasis, aspergillosis, blastomycosis, and pneumocystis pneumonia)Purified protein derivative test and chest radiography at baseline Signs and symptoms of tuberculosis and active hepatitis B (in those who are carriers of hepatitis B virus) Complete blood count, blood urea nitrogen, creatinine level, and hepatic function tests at baseline and periodically TDM in select casesNA ($20,000) Certolizumab pegol (Cimzia)400 mg subcutaneously once at weeks 0, 2, and 4, then 400 mg every 4 weeksInjection site reactions, upper respiratory tract infection, headache, hypertension, rash, infections, autoantibodies/lupus-like syndromeActive tuberculosis, reactivation of latent tuberculosis, invasive fungal infections, lymphoma and other malignanciesPurified protein derivative test and chest radiography at baseline Signs and symptoms of tuberculosis and active hepatitis B (in those who are carriers of hepatitis B virus) Complete blood count, blood urea nitrogen, creatinine level, and hepatic function tests at baseline and periodically TDM in select casesNA ($12,000) Infliximab (Remicade) Infliximab dyyb (Inflectra)5 mg per kg intravenously once at weeks 0, 2, and 6, then 5 mg per kg every 8 weeksInfusion-related reactions (e.g., dyspnea, flushing, headache, rash, chest pain, hypotension, pruritus, urticaria, anaphylaxis), delayed reaction (e.g., serum sickness, myalgia, arthralgia), infections, pneumonia, cellulitis, abscess, skin ulceration, sepsis, bacterial infection, autoantibodies/lupus-like syndrome, lymphomaActive tuberculosis, reactivation of latent tuberculosis, invasive fungal infections, hepatosplenic T-cell lymphomaPurified protein derivative test and chest radiography at baseline Signs and symptoms of tuberculosis and active hepatitis B (in those who are carriers of hepatitis B virus) Dermatologic examination in patients with psoriasis Complete blood count, blood urea nitrogen, creatinine level, and hepatic function tests at baseline and periodically TDM in select casesNA ($5,000; based on 75-kg [165-lb] male)NA ($4,000; based on 75-kg male)Anti-integrin agents Vedolizumab (Entyvio)300 mg intravenously once at weeks 0, 2, and 6, then every 8 weeks thereafterNasopharyngitis, headache, arthralgias, nausea, pyrexia, upper respiratory infection and other infections, hypersensitivity reactions, anaphylaxis, lupus-like syndromeNoneHepatic function tests New onset or worsening of neurologic signs and symptoms Consider screening for tuberculosis TDM in select casesNA ($12,000) Natalizumab (Tysabri) Only available through REMS CD TOUCH prescribing program300 mg intravenously every 4 weeksHeadache, fatigue, upper or lower respiratory and other infections, nausea, arthralgia, depression, infusion-related reactionFatal or disabling PML; not to be used with immunomodulators or anti-TNF agentsAnti–John Cunningham virus antibodySigns and symptoms suggestive of PMLHepatic function testsHypersensitivity reactionsSigns and symptoms of acute retinal necrosisAnti-interleukin 12/23p40 antibody therapy Ustekinumab (Stelara)Weight-based dosing initially by intravenous infusion Up to 55 kg (121 lb): 260 mg > 55 kg to 85 kg (187 lb): 390 mg > 85 kg: 520 mg Maintenance dosing: 90 mg subcutaneously 8 weeks after initial dose, then every 8 weeks thereafterVomiting, nasopharyngitis, injection site erythema, infections, pruritusNonePurified protein derivative test and chest radiography at baseline and periodicallyComplete blood countSigns and symptoms of infection or reversible posterior leukoencephalopathy syndromeTDM in select cases, Crohn’s disease is a type of inflammatory bowel disease (IBD) that goes through periods of no symptoms, known as remission, and periods of active symptoms, known as flares. Crohn’s flare-ups , Crohn’s disease is a type of inflammatory bowel disease (IBD).Around 3.1 million people in the United States have IBD, which affects males and females equally..
Crohn’s disease is a chronic inflammatory condition that affects the gastrointestinal tract. Patients commonly receive corticosteroids to treat symptom flare-ups. Patients with higher-risk , Although there's no firm evidence that any particular foods cause Crohn's disease, certain things seem to aggravate flare-ups. So a food diary can help you identify personal triggers. Beyond that, limit dairy products, eating smaller meals, stay hydrated, and try to avoid caffeine, alcohol, and carbonation., developing Crohn’s disease, it also can trigger . flares. People with Crohn’s disease who smoke tend to have more disease activity, more surgery, and a greater need for medications to control their disease. Crohn’s disease patients who have quit smoking report having fewer flare-ups and a reduced need for medications to control their disease., , , .