This guideline is intended to be an educational device to provide information that may assist us in providing care to patients. This guideline is not a rule and should not be construed as establishing a legal standard of care or as encouraging, advocating, requiring, or discouraging any particular treatment. Clinical decisions in any particular case involve a complex analysis of the patient’s condition and available courses of action. Therefore, clinical considerations may lead a physician to take a course of action that varies from this guideline.
Aminosalicylates Sulfasalazine CBC and CMP -baseline -Q2w x 6, then Qm x 3, then Q6m UA and urinary quantitative microalbumin (morning well-hydrated spot urine specimen) -baseline -Qm x 3, then Q3m x 4, then Q6m
Mesalamine and other 5-ASA agents CBC and CMP -baseline -q12m UA and Urinary quantitative microalbumin (morning well-hydrated urine spot urine specimen) -baseline -Qm x 3, then Q3m x 4, then Q6m
Thiopurines and Other Anti-metabolites 6-mercaptopurine and azathioprine PROMETHEUS® TPMT Enzyme - #3320 -baseline CBC -baseline -q1w x 2, then q2w x 2, then q4w x 2, then q2 m CMP -with every other CBC PROMETHEUS® Thiopurine Metabolites - #3200 Thiopurine metabolite (6-TGN, 6-MMPN) levels -as directed by attending physician Dermatologic examination for nonmelanoma skin cancer -as directed by attending physician
Methotrexate (SC, given weekly at induction dose of 25 mg/w for 3m, then maintenance of 15 mg/w; supplemental oral folate 1 mg/d) CBC, CMP -baseline -monthly Dermatologic examination for nonmelanoma skin cancer -as directed by attending physician
Corticosteroids Budesonide BP and blood glucose -quarterly Ophthalmology examination -annually DEXA -baseline -annually (if stable after 2 annual evaluations, decrease frequency or suspend)
TNF-inhibitors Baseline Chest x-ray PA and lateral PPD with controls or QuantiFERON TB Gold In Tube Coccidioides Antibodies, IgG & IgM by ELISA 0050137 Hepatitis B Virus Surface Antibody 0020090 Hepatitis B Virus Surface Antigen with Reflex to Confirmation 0020089
Vaccination history Annually Pap smear Dermatologic examination for nonmelanoma skin cancer -as directed by attending physician
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