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Diabetes Medications – GLP-1 agonists – Liraglutide (Victoza and Saxenda)

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Diabetes Medications – GLP-1 agonists – Liraglutide (Victoza and Saxenda)

Hello today we will be discussing lira gluted and the brand names of lyra gluted or victoza or saxenda lyra gluten belongs to a group of medication known as glucagon-like peptide 1 receptor agonists or abbreviated as glp-1 receptor icons and these glp-1 agents go to the pancreas and then they enhance the pancreatic beta cells to secrete some insulin and after

Insulin has been stimulated it enters the blood supply and promotes now glucose to enter the body cells and i try to remember the names of the glp one agonist with acronym cell d i mentioned that the glp1 agonists are very expensive and therefore i associate the glp 1 agonist with selling it for a very high amount of dollars thereby the acronym cell d so d for

Dollars s stands for semi-glutat e for excellent l for elixir senate and l for lyric and finally d for doula gluten and the main effects of glp-1 agonists are to increase insulin and thereby lower glucose in the body and as mentioned earlier already the mechanism of lyra gluted and glp-1 agonist in general is also to decrease inappropriate glucagon secretion

First of all what does glucagon mean so glucagon is a molecule just like insulin however it works as a counterpart meaning it acts oppositely so instead of moving now glucose into the cells from the blood it promotes and increases glucose in the blood so once lyricated is in the body it will decrease the inappropriate secretion of this molecule and therefore we

Would have an increased amount of insulin while we would have a reduced amount of glucagon in that sense we will now reduce the glucose in the blood and and that is the main goal here so the second mechanism now is to increase the growth of particular cells found within this pancreas and these are the pancreatic beta cells that secrete insulin and liver gluten

Will now increase and the growth and the replication of the cell and thereby further increase insulin secretion the third mechanism is to slow down the gastric emptying so that food would move more slowly through the stomach and prevent a massive spike of glucose in the blood the fourth mechanism is to decrease food intake by reducing appetite so lyra gluten

Can decrease your appetite in your brain making you eat less and thereby having less glucose in the blood some enzymes in the body can break down or metabolize little regulated and glp receptor agonists in general and these are the peptidyl peptidase iv so dp4 and neutral endopeptidases or nep and why is this important you may ask because we have a different

Medication that can act for instance to prevent this from happening so for example we have medications like deeply before neighborhoods which stop this enzyme however that will be uh discussed then in another video and the dpp and in this presentation i just want to highlight highlight now that the glp one agonist can be degraded or metabolized by the enzyme

But they are resistant to it because synthetic medications are manufactured in the lab for example to be resistant and therefore can work for a prolonged period of time for example 24 hours some glp1 agonies can even last one week and this is really amazing so we can use lyrics as an animal therapy meaning that you add lyra gluten to another medication like

Metformin or lyric but it can also be used as a monotherapy meaning that you prescribe this medication alone without any others so for instance initial metformin treatment if the patient is allergic to it or has contraindications for metformin then literally it can also be used as a substitute so lyrically can also be effective as an atom therapy and not only

For diabetes but also for weight loss patients especially in patients with a bmi of more than 30 30 bmi and also for other conditions related to weight such as hypertension to slip edema and so on and before we give lyra we usually check some parameters such as your weight we check your glucose levels meaning the sugar levels in the blood and we also check the

Hemoglobin a1c and the measurement of hemoglobin aoc just means that we have a glycated hemoglobin molecule and the hemoglobin is the molecule now that transports oxygen in your blood body and the hemoglobin a1c just refers to the glycated part meaning that sugar is is attached to this hemoglobin and this sugar attachment usually happens when glucose is very

High in the body for a very prolonged time and therefore the blood measurement will show that this patient has chronically very high levels note that this is not only at the time of measurement but for a very long time so for example more than three months or so so lyric looted has many advantages over other anti-diabetic medications for example it has a very

High glycemic efficacy when comparing that to other medications and glycemic efficacy just means how good is the medicine at lowering blood glucose levels the second benefit of lyracute is that lifestyle intervention and using the medication can begin simultaneously so meaning that you don’t start with lifestyle changes and then after a couple of months begin

With lyric glute instead you start both at the same time in contrast for example to other medications like metformin where you have lifestyle major lifestyle changes first and the this should be started first before starting the medication but for lyra gluten it is perfect that you can start it immediately lyra gluted is also beneficial for many patients due to

This but also because it’s safe to administer it it’s very good tolerated without gastrointestinal side effects lyra glutet has key advantages in improving insulin resistance or sensitivity or weight loss reducing cardiovascular risk factors however lyric glutes has some disadvantages like like it is expensive for example and that there are common gastrointestinal

Side effects and that the potential risk of medora thyroid carcinoma although this has been seen in only rats but not with humans at the moment uh so not only do we check these three parameters weight blood sugar levels and hemoglobin a1c we also need to exclude these contraindications before we start medications so contraindications are conditions that are

Contrary to or against this medication thus making it inadvisable in simple terms some things have to be ruled out before we start the medication otherwise it is harmful for the patient so one contraindication of lyra gluten is to if we ask the patient if the patient has hypersensitivity to the medication did the patient have an allergy to it if yes never use

We are gluten again and for the second contraindication we need to d we need the details of the patient’s medical history we ask if the patient has a personal history or family history of medullary thyroid cancer personal history here means that did the patient have medullary thyroid cancer in his life okay is it known family history of medullary thyroid cancer

Would refer to it if some of his family members had this type of cancer and if yes then lyra gluten is not advised the third contraindication here is before starting lyrically we need to check whether the patient had multiple endocrine neoplasia syndrome type 2 so men too and if so then lyra gluten is not advised the fourth contradiction is whether the patient is

Pregnant or breastfeeding if so then clear glute is not advised fifth contradiction gastroparesis meaning is the patient having difficulty digesting food or not if yes not advised as we mentioned already one of the mechanism was to slow down gastric emptying and if the patient already has this difficulty digesting it it is slowing it down even further and that can

Be very dangerous so lyric gluten is administered now with a multi-dose pen similar to that of insulin but note that lyric gluten and insulin are very different however lyric gluten can be used with insulin together but it is essential to reduce the dose of insulin to preventing hypoglycemia so low lyric is a lower glucose level and lyric glute is a medication we

Have multi-dose pens as we said we deliver 0.6 1.2 and 1.8 milligram or more okay typically lyric gluten is injected into upper arm thigh or abdomen and if you use the injector to administer 0.6 milligram every day it will last for about 30 days while 1.2 milligram will last for 15 days and 1.8 will last for 10 days and remember to keep the injector pan away from

Heat first wash your hands with soap and water and if you have different injector pens make sure to pick the one labeled as lyric gluted or victoza the second step is to remove the pen cap and attach a new pen needle twisting it to lock it in place and the next step is to remove the needle cover of the injector pen suppose it is the first time you use the injector

Pen clear the air from the needle by holding the pan upwards and moving the die slowly until the flow check symbol line lines up with the dose pointer so you can tap the injector pen gently to move the up air upwards and the drop is seen at the needle when you press the button and note that the dialing knob the push button are both on at the opposite end of the

Needle and after there’s no air in the needle dial the pen back to zero next step is to turn the dosage knob to dial the number of units of lyric glute prescribed and before injecting the lyra gluted select an injection site whether the upper arm thigh or abdomen this disinfect the skin and with one hand then hold this pen such that your thumb is free to reach

The injection button with the other hand gently pinch up the skin around the injection site insert the needle at a 45 to a 90 degree angle making a subcutaneous injection and when you inject it please hold the button for about five to six seconds before releasing it and removing the pen from the injection site okay finally pull out the needle use an alcohol swab

To press if you bleed and so on when the needle is removed and do not rub the injection site the usual dosage depends on the brand of lyra gluten being used saxenda typically for weight loss has a starting dose of 0.6 milligram daily for one week which increases with 0.6 milligram day in weekly intervals until a three milligram daily dose is achieved for victoza

Which is used to treat diabetes the dosage are 0.6 1.2 1.8 milligram and 0.6 milligrams in each of those while 1.2 is the standard dose that may be raised to 1.8 if the hemoglobin a1c levels are not improving the starting those is to get your body used to the medication reducing the side effects and generally lyra gluten can be taken with or without means and

Note that no dosage adjustment is necessary in kidney insufficiency patients however watch out when starting lyrically use or when increasing the dose of this medication while taking lyric we must check your body weight also your heart rate also your blood glucose levels regularly go to your family doctor additionally i would say that we check hemoglobin a1c

About every six months or twice a year in patients who have stable disease and are meeting the treatment goals however we can review it more regularly like every three months in patients who are not meeting the treatment goals okay triglycerides are also measured because lyra gluten is effective on the lipids in the body and it decreases the triglycerides the

Ldl cholesterol the total cholesterol and increases hdl cholesterol so we talked about general information and we about lyric gluten we also talked about the uses of the lyric gluten what to check before giving the medication water we also checked the steps to administer lyra gluten and dosage of lyric and now we will talk about the side effects it is possible

That we can get headaches and nasopharyngeas which means inflammation in the nasal and therax region gastrointestinal problems such as nausea vomiting constipation diarrhea flatulence and abdominal pain and these are the most common side effects and all kinds of abdominal discomforts and most of the lyra gluted side effects are related to the abdomen region

And there can also be injection site reactions meaning that where you puncture your skin can react but this is also rare so allergic reactions can also occur as with all other medications but that is usually rare and as we said with the contraindication part medullary thyroid carcinoma has been seen in very few rodents or mice but to no human at the moment

And that means it can happen but it is impo improbable at the moment and in summary we can say now lyra glutet is a glucagon like pepta one receptor agonist were abbreviated as glp1 the trade names are victoza or saxenda the difference between victoza and saxenda is that saxenda is primarily used for weight loss while victoza is used to treat diabetes and it is

Taken once daily via injection using a multidose pen saxenda has a start dose of 0.6 milligram daily for one week which increases 0.6 milligram per day weekly intervals until 3mg is reached and the dosages for victors are 0.6 1.2 and 1.8 milligram the 0.6 is the initial initial dose 1.2 is the standard dose and before you take this medication we need to make sure

You are not allergic to liver gluten and you or a family member has not had medullothyroid cancer or multiple endocranial endocrine neoplasia syndrome type 2 and if you are pregnant or breastfeeding or having difficulty digesting food then lyra gluten is not advised and once again lyrical side effects are headache nasopharyngitis gastrointestinal problems such

As nausea vomiting constipation diarrhea flatulence abdominal pain injection site reactions and allergic reactions and once again layer gluteus benefits or high glycemic efficacy compared with other diabetic medications it means that it is good at lowering blood glucose levels lifestyle intervention and using the medication can begin simultaneously which means

That you you don’t start with lifestyle changes then after a couple of months you start with little gutted instead you start both at the same time okay lyrics is safe it’s easy to administer and many patients tolerate it without gastrointestinal side effects so many patients lyra glute is key advantage of improving insulin resistance or sensitivity weight loss

Reducing cardiovascular risk factors and i think that’s enough thank you for watching and until the following video now take care bye bye

Transcribed from video
Diabetes Medications – GLP-1 agonists – Liraglutide (Victoza and Saxenda) By Dr. Andras Fazakas