Exenatide for Type II Diabetes.
Hi my name is tuivo and i’m going to be talking about a xenotide also known as bayeta and by durian so to start off a xenotype belongs to a class of medications called glucagon like peptide 1 agonist they are approved for use in patients with type 2 diabetes and it’s available in two forms of subcutaneous twice daily dosing which is known as the bayeta the
Subcutaneous weekly dosing which is the baidurian and the xenotide decreases a1c by 0.5 to one point five percent so i’m going to go over how to use the bayeta pens so you want to inject two times each day within 60 minutes before morning and evening meals at least six hours apart and you want to prime each pen the first time you use it so i’m gonna go over
How to prime it based off the graphic below so you want to pull off the blue pen cap you want to check that the liquid is clear colorless and free of particles and if you see air bubbles that is normal then you want to remove the paper tab from outer needle shield you want to push the cap needle straight onto the pen and screw the needle on until it is secure
Then you’re going to pull off the outer needle shield and you’re not going to be throwing this away pull off the inner needle shield and throw that away and then you want to make sure to check that the right arrow is in the dose window i’m gonna pull the dose knob out until it stops and the arrow pointing up is in the dose window then you’re gonna turn the
Dose knob away from you until it stops and the number five is in the dose window so with the needle pointing up you want to firmly push injection button in all the way until it stops and keep holding the injection button firmly and slowly count to five you’re going to watch for a stream of several drops and then when the arrow pointing up is in the center of
The dose window the pen is ready to reset you can then turn the dose knob away from you until it stops an arrow pointing down is in the dose window so to go over how to use the bayeta pen you first want to attach the needle onto the pen so first step you want to do is wash your hands prior to use pull off the blue pen cap and check that the cartridge is clear
In terms of the liquid it’s colorless and free of particles if you do see air bubbles that is normal second step is to remove the paper tab from outer needle shield you want to push the cap needle straight onto the pen make sure that you use a new needle for each injection and screw the needle on until secure third step is to pull off outer needle shield do not
Throw this away then you pull off the inner needle shield and throw it away a small drop of liquid may appear but this is normal step 4 to dial the dose you want to check that the arrow pointing right is in the dose window if not you want to turn the dose knob away from you clockwise until it stops an arrow pointing right is in the dose window step 5 pull dose
Knob out until it stops an arrow pointing up is in dose window step six is turn dose knob away from you until it stops and the number three is in the dose window step seven to inject the dose grip the pen firmly in your hand insert the needle into your skin use thumb to firmly push injection button in all the way until it stops and keep holding ejection button
Firmly and slowly count to five to deliver full dose then remove needle from skin so you can tell that injection is complete when arrow pointing up is in the center of dose window step nine is to reset the pen by turning the dose knob away from you clockwise until it stops and the arrow pointing right is in the dose window step 10 is to carefully replace outer
Needle shield unscrew the needle and place in a puncture resistant container just a few things to note is that each dose should be administered in the thigh abdomen or upper arm and each pen contains enough drug to inject a dose twice daily for 30 days so to go over by durian single dose vial slash tray this medication requires you to mix the powder medication
With the liquid in a syringe once mixed it must be injected immediately otherwise clumps will form you want to insert the needle into the skin push down on the syringe plunger with your thumb until it stops then withdraw the needle now i’m going to go over patient consultation for the by durian pen so you want to remove one pen from the fridge and let it stand at
Room temperature for at least 15 minutes check out the liquid inside the inspection window to make sure it is clear before your particles air bubbles are normal you want to screw the needle onto the pen with the pen upright slowly turn the knob at the end of the pen until you hear the click and the green label disappears hold the pen by the end with the orange
Label and tap the pen firmly against the palm of your hand tap for about 80 times rotating the pen every 10 taps one mix by durian both formularities will be uniformly cloudy solution with no clumps then you’re going to hold the pen with the needle pointing straight up and turn the white knob until the orange label disappears and the injection is released insert
The needle into the skin press injection button firmly until you hear a click count to 10 before withdrawing the needle so i’m going to go over by durian b size you want to remove one pen from the fridge and let it stand at room temperature for at least 15 minutes you’re gonna mix the medicine by holding the device with the orange cap facing up shake the entire
Device up and down for at least 15 seconds look at the medication window to make sure it is fully mixed when fully mixed you can inject right away to inject you want to turn the bottom knob from lock to unlock position until you hear a click you will see a plunger appear in the window then you will unscrew the orange cap a green shield will appear this covers
The needle you want to push the edge of the green shield against your skin until you hear a click hold the device in place for at least 15 seconds when finished you should see an orange rod in the window remove the needle and discard the entire device a few things to note for all of the by durian is that it is taken once weekly if a dose is missed take it as
Soon as you remember as long as the next regularly scheduled dose is at least three days later if the next dose is less than three days later skip the mist dose entirely and continue with the next regularly dosing day also each pre-filled pen comes with one dose of medication and must be disposed of after single use so dosing and adjustments for bayeta include
It starts at 5 micrograms subcutaneously twice a day for a month this can be increased to 10 micrograms subcutaneously twice a day with patients that have end stage renal disease or creatinine clearance less than 30 mls per minute this medication is not recommended and for by darion it’s two milligrams subcutaneously once weekly and patients with end-stage renal
Disease or creatinine clearance less than 30 mls per minute is not recommended so mechanism of action of a xenotide is that it’s an analog of the encrypting hormone glp-1 so once food enters the stomach it goes to the small intestines and cretins are hormones that are released from gi tract because of the food that we ingest this increases insulin from the beta
Cells in the pancreas and decreases glucagon the overall effect is that plasma glucose is reduced this can slow gastric emptying improve satiety and it can result in weight loss so warnings and side effects of a xenotide there is a black box warning for by durian with the risk of thyroid c cell carcinomas there’s two warnings left by durian for pancreatitis
And for gastroparesis for pancreatitis it can be fatal usually in patients with risk factors such as history of pancreatitis gulf sounds alcoholism or increasing triglycerides with gastroparesis it’s not recommended in patients with severe gi disease other side effects for xenotype include nausea which is primary side effect vomiting diarrhea hypoglycemia weight
Loss and injection site reactions so the monitoring parameters for xenotide include blood glucose a1c level and renal function
Transcribed from video
Bydureon and Byetta for Type II Diabetes By Riverside Rx Services