The increasing use of corticosteroids, immune modulators, and biologics as a mainstay of therapy in certain Crohn's disease and ulcerative colitis patients have placed these inflammatory bowel disease (IBD) patients at increased risk for a variety of infections, many of which are preventable by prior vaccination. This article provides a review of the issues surrounding immunizations in the IBD patient and a practical guide for clinicians regarding the appropriate vaccinations to administer both before and during immunosuppressive therapy.
The temporal relationship of gatifloxacin administration and the hypoglycemic episode suggests that gatifloxacin likely precipitated the event. Clinicians should be aware of this adverse effect in patients taking gatifloxacin presenting with hypoglycemia.
Currently, inhaled iloprost offers potential benefit for patients with contraindications to bosentan, preference for non-parenteral products, ineligibility for parenteral therapy, or as adjunctive therapy with other pulmonary vasodilators. Larger, long-term clinical trials are needed to solidify the role for inhaled iloprost in the management of PAH.
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