Recent Advances In GI Pharmacology

Fecal Microbiota Transplantation

 The initial line of treatment for Clostridium difficile infections; the extensive clinical trials contrasting vancomycin and fidaxomicin
  Harrison claims that the effectiveness of fidaxomycin and oral vancomycin in clearing infections is comparable. First-line medications are vancomycin and fidaxomicin.

According to a recent recommendation by the Infectious Disease Society of America, C. difficile infection. Fidaxomicin is the first-line treatment. Research indicates that Vancomycin has the lowest Fidaxomicin and a lower recurrence rate than Metronidazole.

Between 50 and 30 percent of patients have a recurrence. Fidaxomicin is currently advised to be used as a first-line medication.

What Are The Options If Recurrence Happens After Using Fidaxomicin?

Transplanting fecal microbiota. The outcomes of randomized controlled trials of fecal microbiota transplantation (FMT) for recurrent CDI are still being published; predictably, the outcomes are not as good as those of observational trials. Nevertheless, FMT is not authorized for use in the US by the FDA.

The FDA-approved living culture Rebyota. It is administered as a single, 150 ml instillation dose. This is being used to treat recurrent CDI. The NG tube for Vancomycin/Fidaxomycin and fulminant CDI IV Metronidazole are available. • PUNCH CD-3 revealed that patients treated with Fecal Microbiota improved six months after transplantation.

Risankizumab           

First, for patients with moderate to severe Crohn's disease who have not responded to or are unable to take TNF alpha-blocker therapy, IL23 blocker therapy is approved.  Accepted for both maintenance and induction.

Two trials: advanced and motivational; IV 600; 0, 4, 8 weeks; maintenance: 1 in 12 weeks; 180–360 mg; fortify trial–maintenance.                                                                

Vonoprazan            

PPIs are H+ and K+ blockers; all medications ending in "azan" are potassium-competitive acid blockers. Similar effects are also produced by PCAB, which blocks potassium binding sites competitively. blocks protons that are both active and inactive.
PPIs have a peak impact that lasts between three and five days, but PCABs have a single dose. Additionally, PCABs are more potent than PPIs and operate more quickly.

Double and triple combination therapy based on vanoprazan that has FDA approval for treating H. pylori infection. Vanoprazan, erythromycin, and amoxicillin together constitute a triple combination medication. Vanoprazan and Amoxycylin is another combination, a two-drug combo. Both can be used to treat H. pylori infections. The FDA suggests waiting 10 days.

Also Read: Important topics in Pharmacology for NEET-PG

Upadacitinib

Inhibitor of Janus Kinase;  JAK-STAT pathway.  JAK 1; JAK 2; JAK 3; tins; erythropoietin; thrombopoietin; growth hormone; ters; interferons; interleukins;Combinations of the two aforementioned types—JAK 1, JAK 2, and JAK 3—make up receptors. Whereas upadacitinib is a selective JAK 1 inhibitor, tofacitinib is a non-specific JAK inhibitor. It can be used to treat moderate-to-severe Crohn's disease and moderate-to-severe Ulcerative colitis in individuals who have not responded to or are intolerant of TNF alpha therapy.

Also Read: Achalasia Cardia- Clinical Features, Diagnosis And Treatment

Hope you found this blog helpful for your NEET SS Gastroenterology and Hepatobiliary preparation. For more informative and interesting posts like these, keep reading PrepLadder’s blogs.