Outcome Evaluation

• Monitor for improvement of symptoms in patients with active IBD, such as reduction in the number of daily stools, abdominal pain, fever, and heart rate.

• For patients in remission, assure that proper maintenance doses of medications are used and educate the patient to seek medical attention ifsymptoms recur or worsen.

• Evaluate patients receiving systemic corticosteroid therapy for improvement in symptoms and opportunities to taper or discontinue corticosteroid therapy. For patients using more than 5 mg daily of prednisone for more than 2 months or for steroid-dependent patients consider the following:

• Central bone mineral density testing to evaluate the need for preventive or therapeutic bisphosphonate therapy;

• Periodic monitoring of blood glucose, lipids, and blood pressure;

• Evaluation for evidence of cushingoid features or signs or symptoms of infection.

• When considering treatment with azathioprine or 6-MP, obtain baseline CBC, liver function tests, and TPMT activity. These tests should be monitored closely (every 2-4 weeks) at the start of therapy and then approximately every 3 months during maintenance therapy.

• With azathioprine and 6-MP, monitor for hypersensitivity reactions, including severe skin rashes and pancreatitis. Educate the patient regarding signs and symptoms of pancreatitis (nausea, vomiting, and abdominal pain).

Anxiety and Depression 101

Anxiety and Depression 101

Everything you ever wanted to know about. We have been discussing depression and anxiety and how different information that is out on the market only seems to target one particular cure for these two common conditions that seem to walk hand in hand.

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