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Sulfasalazine, sold under the brand name Azulfidine among others, is a medication used to treat rheumatoid arthritis, ulcerative colitis, and Crohn's disease. [5] It is considered by some to be a first-line treatment in rheumatoid arthritis. [ 6 ]
Once remission is induced, maintenance levels can be used: sulfasalazine 2 g/day, mesalamine 1.2-2.4 g/day, or olsalazine 1 g/day. Patients on high dose sulfasalazine require folic supplementation (1 mg/day) because it inhibits folate absorption. If oral Mesalazine is still not working, prednisone is often given, starting at 40–60 mg/day.
Azathioprine and 6-MP may be useful for the following indications: Maintenance therapy with azathioprine or 6-mercaptopurine may lead people with active Crohn's to take less steroid medication. This may lower side effects related to steroid treatments. [9] Fistulizing disease [11] Maintenance of remission after surgery for Crohn's disease [12]
The opposite of an indication is a contraindication, [4] a reason to withhold a certain medical treatment because the risks of treatment clearly outweigh the benefits. In the United States, indications for prescription drugs are approved by the FDA. Indications are included in the Indications and Usage section of the Prescribing Information.
A key component to the allergic response to sulfonamide antibiotics is the arylamine group at N4, found in sulfamethoxazole, sulfasalazine, sulfadiazine, and the anti-retrovirals amprenavir and fosamprenavir.
For ulcerative colitis, sulfasalazine has been demonstrated to be beneficial in treating flare-ups as well as the underlying condition; [29] however, the picture for Crohn's disease is less clear. Sulfasalazine has been demonstrated to be beneficial in certain trials for Crohn's disease, [30] but not in others. [31]
Currently, its use is limited to emergency surgery when immediate anastomosis is not possible, or more rarely it is used palliatively in patients with colorectal tumours. [ 1 ] The Hartmann's procedure with a proximal end colostomy or ileostomy is the most common operation carried out by general surgeons for management of malignant obstruction ...
Surgical positioning is the practice of placing a patient in a particular physical position during surgery. The goal in selecting and adjusting a particular surgical position is to maintain the patient's safety while allowing access to the surgical site. Often a patient must be placed in an unnatural position to gain access to the surgical site ...