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Nesina for the Treatment of Type II Diabetes

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Alogliptan for Type II Diabetes.

Hello my name is raymond chao and i am a pharmd candidate of 2021 and in this video i will be talking about nissina also known as allogliptin first we’ll start by going over counseling points for our patients who will be starting on this medication allogloptin is used to lower blood sugar in people with type 2 diabetes it is taken once daily with or without food

Continue to take this drug even if you feel well that being said do not stop taking this medication unless the doctor instructs you to do so use this medication in addition to a healthy diet and exercise to help lower blood sugar take missed doses as soon as you remember however if it’s close to the timing of your next dose skip the missed dose and take the

Medication at your normal time do not take two doses at the same time although the medication is unlikely to cause low blood sugar or hypoglycemia on its own risk for low blood sugar is higher when taken together with other medications that cause hypoglycemia which include insulin or esophageria such as glyposide or glymepyride those other medications may need

A dose reduction common side effects include running your stuffy nose headache sore throat and cold like symptoms report to your doctor right away if you experience any signs of allergic reactions such as hives or rash difficulty swallowing or breathing or any swelling of the face lips or throat also report any signs of liver problems which include nausea

Or vomiting stomach pain fatigue dark urine and yellowing of the skin or eyes finally report any joint pain and any skin reactions as well now we’re going to go more in depth of necesena it is a dipeptidyl peptidase 4 or dpp4 inhibitor it’s indicated to be used as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes it is

Not indicated for the treatment of type 1 diabetes or diabetic ketoacidosis the medication does require renal dose adjustments and it can be used in patients with renal impairment and even end-stage renal disease unlike other dpp-4 inhibitors allogliptin is available as generic now let’s talk about its mechanism of action natural and creatine hormones such as

Glucon-like peptide 1 or glp-1 is released by the small intestines in response to meals these hormones cause glucose dependent insulin release from pancreatic beta cells and lowers glucagon secretion from alpha cells which then in turns reduce hepatic glucose production those hormones are inactivated by the dpp-4 enzymes allogloptin inhibits this inactivation

Of increasing hormones and thereby increases their concentration which then lowers glucose concentrations some of the effects that we would expect is that it will lower a1c by about 0.5 to 1 percent and the medication has neutral weight changes meaning that it neither causes weight gain nor weight loss the medication is formulated in three different tablets at

25 milligrams 12.5 milligrams and 6.25 milligrams and once again this medication is available as generic the recommended dose is 25 milligrams once daily for renal adjustment you do not have to dose adjust for patients with creatinine clearance greater than or equal to 60. for those who fall between 30 and 60 in creatinine clearance we want to dose adjust to 12.5

Milligrams once daily and for any patients have a creatinine clearance below 30 we want to adjust that dose of 6.25 milligrams once daily per the manufacturer’s labeling there are no hepatic dose adjustments however we want to use caution in patients with liver disease warnings for this medication include acute pancreatitis heart failure hepatotoxicity concurrent

Use with medications known to cause hypoglycemia which and then in turns may require dose reductions of insulin and or insulin secreto gogs to avoid hypoglycemia arthralgia bolus pemphigoid we want to avoid concurrent use with a glp-1 receptor agonist due to the lack of added glycemic benefit the only contraindication for this medication is hypersensitivity

Adverse reactions include nasal pharyngitis which presents itself with stuffy nose runny nose or sore throat headache and upper respiratory tract infections which present as cold like symptoms to monitor for efficacy we want to look at hemoglobin a1c and we’re going to do this quarterly in patients who are not meeting their treatment goals or after a therapy

Change and for other patients who do have stable glycemic control who are at treatment goals we want to monitor those patients at least twice a year we also want to look at serum glucose as well for efficacy to monitor for safety we want to look at renal functions liver function tests signs of symptoms of pancreatitis and signs of symptoms of heart failure

Transcribed from video
Nesina for the Treatment of Type II Diabetes By Riverside Rx Services