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Diabetes Medications – GLP-1 agonists – Exenatide (Byetta and Bydureon)

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Diabetes Medications – GLP-1 agonists – Exenatide (Byetta and Bydureon)

Hello today we will discuss excellent and anti-diabetic medication and excellent is an injectable medication approved to treat type 2 diabetes and it works to control high blood glucose levels and excellently it can be used alone or with other medications depending on the patient’s needs so excellent it has internationally a recognized trade name of baeta or

Baidurian and if you’re familiar with anti-diabetic medications you may notice that the excellent it comes in an injection pen similar to other medicines such as lyra gluten called victoza and doula gluten called trulicity and the similarity is because excellent it also belongs to the family of glp1 agonists so the glp-1 stands for glucagon like peptide one and why

Agonists refer to the agents that activate the receptors in some special cells called the beta cells within the organ pancreas to secrete insulin which then further goes into the blood and then moves glucose or sugar from the blood into the cells and glp1 agonists have many functions in the body that benefit people with type 2 diabetes and to remember the names of

The glp 1 agonist the acronym cell d makes it very easy cell d is simple to recall as these medications can be expensive at the moment and s stands for semi-glutat e for examinated l4 elixir synaptic l4 lyra glutathione and finally d4 doula glutathione and it is good to keep in mind that because these injection pens that contain the medicine may look similar and

It is always good to ensure that you check the label or any medication before using it and if you are familiar with diabetes as a disease you would know that the problem in diabetes is that the pancreatic beta cells reduce in number until insulin cannot be produced by the body animal any longer and however the glp1 agonies now which include excellent stimulate

The growth of these cells and thereby enhance the secretion of insulin from these pancreatic beta cells and another mechanism of excellent and other glp one receptor arguments is to reduce the inappropriate glucagon secretion and in simple terms glucagon is a molecule similar to insulin but works as its counterpart meaning that glucagon acts in an opposition

To insulin so instead of moving glucose into blood cells it promotes and increases glucose in the blood okay excellent and other glp1 receptor agonists can prevent the effects of glucagon so when excellent is in the body it will reduce the inappropriate secretion of this glucagon molecules and therefore the overall impact causes an increased amount of insulin

While having a reduced amount of glucagon and in essence this means it will reduce glucose in the blood which is the primary goal in diabetic patients so excellent it has many advantages over other diabetic medications the one benefit of excited is that it improves insulin sensitivity as mentioned before it enhances the secretion of insulin from the pancreatic

Beta cells while stimulating the growth of these insulin producing cells and therefore it increases your body’s insulin sensitivity as the overall effect and causes a raised amount of insulin while reducing glucagon which is immensely beneficial in diabetic patients note that this is why patients who are already using insulin and sulfonylurea treatment need to

Have their dosage reduce a little bit before starting glp-1 agonist including excellent for example the second benefit is that it has a very high glycemic efficacy compared with the other diabetic medications so glycemic efficacy just means how good the medicine is at lowering blood glucose levels therefore we can say now that excellent it has a good glucose

Lowering effect in the body third benefit is that the administration of excellent it is pretty straightforward the medication comes in two types baeta and this is a short acting and is injected twice daily while by durian is long acting and is injected once weekly so excellent it has some disadvantages also like any other medication one simple drawback is that

Some patients prefer oral medicines but excellent it does not favor this preference since it is only available as an injection another disadvantage is that some patients experience a loss of appetite and gastrointestinal side effects and we will expand on this later on so before we give now excellent some parameters such as your weight your glucose levels in the

Blood and hemoglobin a1c have to be checked so hemoglobin is the molecule that transports oxygen in your body and hemoglobin a1c refers to the glycated part meaning the sugar attached to this hemoglobin and this sugar attachment usually happens when glucose is very high in the body for an extended time so therefore the blood level measurement will show now that

This patient has a chronically very high level notably this this result is not only at the time of the hemoglobin a1c measurement but for a long duration such as for example three months or more and it is sensible to keep checking these parameters mentioned before and ensure the kidney and the pancreas and the gallbladder are functioning well as you as you use

This medicine contraindications need to be excluded now before starting any medications and they make taking medicine inadvisable because it would rather be harmful to the patient so excellent is no exception so some things have to be ruled out now more in more straightforward terms we can say that the medication to know um the contraindication to know first of

All is uh that the hypersensitivity that you can see in many other medications uh can also be seen with excellently so if you ask if the patient had an allergy before and if so then don’t use this medication for the second contraindication we require the details of the patient’s medical history and we can ask if the patient has for example a personal history

Or family history of medullary thyroid cancer or personally so personal history just means that the patient have had middle ear thyroid cancer in his life and it is is it known or not family history means just that it was some family member having this type of cancer and if yes the excellent it should not be given third contraindication is whether the patient

Had multiple endocrine neoplasia syndrome type 2 or men ii and if so then excellent it is not advised for the next contradiction i would say that we ask if the patient has a personal history or family history or for example pancreatitis or kidney disease personal history means as we said did the patient have pancreatitis or kidney illness in his life family

History would refer to if if some family member had it and if yes then excellent is not advice since it can be very harmful in such cases so next contraindication is whether the patient is pregnant or breastfeeding if so excellent is not advised however it can be used but will require careful monitoring by the doctor who prescribed it so last contraindication

Is gastroparesis which means that patient is having difficulty digesting food and one of the effects of glp-1 receptor agonist is to slow down the gastric emptying and if the patient already has difficulty digesting and and and then we slow down it even further that can be dangerous so excellent it is not advised if that is the case okay excellent is administered

With a pre-filled injector pen similar to that of insulin or lexic the injector pen comes in two distinct colors so you can easily differentiate the types baetta has a blue and yellow injector pen while baidurian has an injector pen in a gray or white color often with an orange cover so before taking any medication make sure to read the label correctly baeta is

Short acting while baidurian is long acting and both types of excellent should be subcutaneously injected into the abdomen thigh or upper arm and we administer baetta twice daily usually during an hour before you eat a breakfast and the dinner the patient has to make sure that there are at least six hours in between the two doses and it is advisable to even set

The alarm clock or notification in the phone for the medication time or have a family member remind you to take it and it is also advised that you use baeta with the starting subcutaneous dose of 5 micrograms daily however this can be changed to 10 micrograms twice daily for additional glycemic control if the initial doses did not improve blood glucose levels

Additionally glycemic control means improving your blood glucose control to keep it in normal levels and suppose you forget to use baeta before you before the usual meal for instance and if you miss it before the breakfast note that you do not inject it after you have eaten instead use it before your next meal which means that you miss those should be skipped

And resumed at the next scheduled dose and it is best to store your unopened packs of baeta and baidurian in a refrigerator between two to eight degrees celsius to not freeze it and make sure to keep it away from direct heat and sunlight and we administer by the way now once weekly at any time of the day regardless of the meal however by doing must be given

On the same day each week so to do it effectively you pick a day like sunday and which you can easily remember then you set the reminder on your phone or let somebody notify you on those days however suppose you forget here also the dose of baidurian when should it be administered again if there are less than three days until the next scheduled dose skip the

Missed toes and resume at the next scheduled dose therefore by deriving should be given as soon as possible within three days and the time between the two injections should be at least 72 hours and the recommended dosage of baidurian is two milligram once weekly and let’s now discuss some important details related to the baeta and by the way pre-treatment with

Short-acting excellented or baeta is not needed before starting with a long-acting excellent or by durian another interesting point is that when switching from short-acting excellente or biota to long-acting excellent or by durian the patient must stop taking the bayeta for at least one day so once the patient stops ballieta one day later the patient can start

With baidurian treatment and once such a switch from a short acting extended so bieter to a long-acting accident by durian is made then there will be an increased blood glucose levels for about two to four weeks and also note that no dosage adjustment is necessary for liver insufficiency patients which is very good news however watch out when starting excellent

Use or when increasing the dose of the medication so watch out so now let’s look at how to inject yourself with excellent which we know has trade themselves baeta and baidullion the following steps are specifically for by durian however injecting baeta has very similar steps remember to always prime the needle before injecting excellent priming is only done the

First time you use the new injector pen so start by pulling the button up then turn the pen with the needle pointing upwards and gently tap it and push the injector button for a few drops to come out ensuring no air bubbles in the syringe and the solution should appear clear colorless okay the first step is to select an injection site with an upper arm thigh or

Abdomen disinfect the skin remember to rotate the injection size for any following injections and even if you take insulin injections please choose an alternative location not at the same spot second step is to shake the out injector for about 15 seconds to mix the medication and the mixture should look cloudy third step is to turn the bottom of the auto injector

To the left to unlock it and next turn the cap counterclockwise so the green shield will pop up and make sure to disinfect the skin area of the abdomen and then puncture the skin and press the button hold this for 15 seconds until the orange bar appears and the last step is to remove the injector pad from your skin safely dispose the sharp needle and that was

It excellent it has several benefits but one of its main drawbacks was its side effects mainly related to digestion in less than in less than 10 of cases actually the most common side effects are all kinds of abdominal discomfort and loss of appetite and the possible gastrointestinal problems include for example nausea vomiting constipation diarrhea flatulence

Abdominal pain and so on injection site reactions can also occur but these are rare and can occur with any injected medication and we have covered now generally general information and its uses what to check before giving the medication the steps on administering it the dosage and its benefits and side effects and now let’s have a summary to highlight these key

Points so excellent is an anti-diabetic medication at it is in the category of glp one agonist the glp-1 agonists include semi-gluten excellent lexical lyra gluten and doula gluten and remember the acronym of cell d for glp anagonist the trade names of exanated are baeta and by durian excellent it is explicitly used as a medication in diabetes mellitus type

2 and can be used alone or in another medication with another medication so the recommended recommendation of the type short acting or or so is uh we have for example five and ten microgram of the short acting one the long acting one by durian has a usual dose of two milligrams once weekly and benefits of excellent are for example we have high glycemic efficacy

Meaning it improves the insulin sensitivity it has an excellent glucose lowering effect the other advantage was that it is easy to administer additionally we can say that it is unique since uh it’s possible to have it either in a short acting form the baeta or in long-acting form the pythorium depending on the patient’s needs so i think this was enough thank you

Very much for listening take care and look at the other videos also bye bye

Transcribed from video
Diabetes Medications – GLP-1 agonists – Exenatide (Byetta and Bydureon) By Dr. Andras Fazakas