Pharmacology: GLP-1 Receptor Agonists

Question 1

what type of drug are GLP-1 receptor agonists

Answer 1

incretin, insulin secretagogues

Question 2

what is the GLP-1 receptor agonists mechanism

Answer 2

GLP-1 like molecules modified to avoid the breakdown of DPP4, can also alter half life

Question 3

how do GLP-1 receptor agonists need to be administered

Answer 3

injection, not orally

Question 4

how does the pharmacological effect of GLP-1 receptor agonists compare to that of DPP4i

Answer 4

far greater then DPP4i

Question 5

what action do GLP-1 receptor agonists have relevant to diabetes

Answer 5

act to promote insulin secretion in glucose dependant mechanism, also lowers glucagon(which is increased in T2DM)

Question 6

what are some of the systemic actions of GLP-1 receptors

Answer 6

reduce appetite by acting on hypothalamus and act on intestine to reduce gastric emptying

Question 7

how potent are GLP-1 receptors

Answer 7

quite potent, reduce HbA1c by arund 11-15mmol/mol

Question 8

what effect do GLP-1 receptor agonists have on weight and BP

Answer 8

weight = 2-3kg loss
BP = lower

Question 9

what is the most commonly used GLP-1 receptor agonist

Answer 9

Liraglutide

Question 10

what are some of the side effects of GLP-1 receptor agonists

Answer 10

nausea, vomiting(improves after 6 weeks), gallstones risk increased

Question 11

what effect do GLP-1 receptor agonists have on CV risk

Answer 11

have been shown to reduce CV mortality by 12-20% for some GLP-1 RAs

Question 12

where do GLP-1 RAs fit in the step by step treatment of T2DM

Answer 12

second line in those with compelling reason to minimise hypoglycaemia, OR those with compelling reason to lose weight, OR if significant CV risk or disease