Journal of Addiction Medicine
The correlation between delayed gastric emptying and GLP-1 RAs raises concerns about the possible negative effects in the periprocedural setting, as evidenced by case reports of aspiration events occurring during procedural anesthesia in patients administered GLP-1 RAs [14,15]
, 534 , 604-609, Serebryakova, M., Tsibulskaya, D., Mokina, O., Kulikovsky, A., Nautiyal, M., Van Aerschot, A., Severinov, K., and Dubiley, S
You should inject medication into your: Stomach: Stay at least two inches away from your belly button and avoid scar tissue
10% excreted unchanged by the kidney contraindicated: hepatic dysfunction renal insufficiency Glimepiride: (Amaryl) monotherapy -- once a day administration or in combination with insulin most potent -- lowest dose of the sulfonylureas long duration of action: half-life = 5 hours hepatic metabolism: complete to inactive products Secondary Failure and Tachyphylaxis to Sulfonylureas: Treatment failures occur Possibly due to pancreatic B cell refractoriness or to loss of dietary compliance Combination of sulfonylureas and insulin would appear justified only in the presence of severe insulin resistance Metformin: (Glucophage) glycolysis stimulation-- increased glucose removal from blood decreased hepatic gluconeogenesis decreased glucose absorption rate from the GI tract reduced plasma glucagon in patients with refractory obesity and insulin resistance Advantages: does not cause hypoglycemia does not increased weight May be used in combination with sulfonylureas when sulfonylurea monotherapy is not effective most common -- gastrointestinal (20% frequency) anorexia, nausea, vomiting, diarrhea dose-related usually occurs upon initiation of therapy -- often transient in effect Decreased vitamin B 12 absorption
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