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NAME: GLP-1 receptor agonists: exenatide (Byetta), lixisenatide (Adlyxin), liraglutide (Victoza), albiglutide (Eperzan), dulaglutide (Trulicity), and semaglutide (Ozempic)MOA: Activate GLP-1 receptors in the pancreas, leading to increased insulin release and decreased glucagon releaseClinical: Clinically indicated for the treatment of type 2 diabetes mellitus, particularly in patients with atherosclerosis, heart failure, or CKD. High-dose liraglutide is also FDA approved for weight loss in obesityADME: Most are poorly bioavailable and require SQ injection, oral semaglutide is available, renally cleared and requires dose adjustment in mild renal dysfunction and contraindicated in renal failureAE: Most frequent are GI symptoms: diarrhea, nausea, vomiting . Can also cause dizziness, mild tachycardia (~10 bpm increase), infections, headaches, and dyspepsiaContraindications: Hypersensitivity, pregnancy (contraception must be used in women of childbearing age), severe gastrointestinal disease, personal or family history of thyroid cancer, ese with caution in patients with severe renal dysfunctionInteractions: Combination with dipeptidyl peptidase-4 inhibitors is not recommended due to lack of increased efficacy and incidence of hypoglycemia induction
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