GLP-1 Receptor Agonists

Question 1

Give 2 examples of GLP-1 receptor agonists

Answer 1

• Exenatide

- Liraglutide

Question 2

What is the mechanism of action of GLP-1 receptor agonists?

Answer 2

Bind to, and activate, the GLP-1 receptor to increase insulin secretion, suppress glucagon secretion, and slow gastric emptying

Question 3

What are the routes of delivery of GLP-1 receptor agonists?

Answer 3

SC

Question 4

What are the indications for GLP-1 receptor agonists?

Answer 4

Type 2 diabetes

Question 5

What are the contraindications to GLP-1 receptor agonists?

Answer 5

• Diabetic ketoacidosis
• Severe GI disease
• Pregnancy and breastfeeding

Question 6

When should GLP-1 receptor agonists be used with caution?

Answer 6

• Elderly

- Renal impairment

Question 7

What might GLP-1 receptor agonists interact with?

Answer 7

• Warfarin
• Other anti-diabetic drugs
• Alcohol
• Steroids

Question 8

What might happen if GLP-1 receptor agonists are given with warfarin?

Answer 8

Increased anticoagulant effect

Question 9

What might happen if GLP-1 receptor agonists are given with other anti-diabetic drugs, alcohol, or steroids?

Answer 9

Increased risk of hypoglycaemia

Question 10

What monitoring is required with GLP-1 receptor agonists?

Answer 10

• Monitor HbA1c and blood glucose every 6 months

- Monitor weight

Question 11

What are the common side effects of GLP-1 receptor agonists?

Answer 11

• GI upset

- Weight loss

Question 12

What are the less common side effects of GLP-1 receptor agonists?

Answer 12

• Severe pancreatitis
• Hypoglycaemia
• Anaphylactic reactions

Question 13

What can potentially happen to the pancreas with GLP-1 receptor agonists?

Answer 13

Can become haemorrhagic and necrotising

Question 14

What patient counselling is required with GLP-1 receptor agonists?

Answer 14

• Not with food
• Missed doses
• Concomitant use of medications
• When to seek help
• Stop immediately in acute pancreatitis
• Driving advice
• Contraception

Question 15

What should the patient be told about missed doses of GLP-1 receptor agonists?

Answer 15

If you have missed a dose, take the next dose as scheduled

Question 16

What should the patient be told about concomitant use of medications with GLP-1 receptor agonists?

Answer 16

Some drugs, e.g. sulphonylureas, will require dose adjustment if used concomitantly

Question 17

What should the patient be told about when to seek help with GLP-1 receptor agonists?

Answer 17

If nausea, vomiting, or severe abdominal pain occurs

Question 18

What should the patient be told about acute pancreatitis with GLP-1 receptor agonists?

Answer 18

If it is suspected that acute pancreatitis has developed as a result of this drug, the drug must be stopped immediately in addition to seeking medical help

Question 19

What shouldWhat should the patient be told about contraception with GLP-1 receptor agonists?

Answer 19

Women of child-bearing age should use effective contraception during treatment with modified-release exenatide and for 12 weeks after discontinuation