New drugs: Exenatide – an injectable diabetic agent and Denosumab – a monoclonal antibody for postmenopausal osteoporosis

Exanatide (Byetta): the first injectable synthetic analogue of the incretin hormone glucagon-like peptide-1 (GLP-1) note that the glyptins inhibit incretin breakdown and are thus incretin “enhancers” not “mimics” PBS approved for type 2 diabetics as an addition to the combination of metformin and  sulphonylurea to help lower HbA1c below 7% or as dual Rx for those who cannot tolerate metformin or a sulphonylurea. dose: is given bd s/c within 1 hour BEFORE meals starting at 5 mcg per dose which should be at least 6 hours apart after 1 month, dose can be increased to 10mcg bd main adverse effects are: nausea (50% initially) vomiting risk of hypoglycaemia (this risk is similar to use of insulin and mainly a risk with sulphonylurea combination) pancreatitis – PH of pancreatitis is a C/I! renal impairment development of antibodies which in some may limit its effect (~3% of the 50% of patients who develop antibodies) the actions include: increase glucose-dependent insulin secretion suppress inappropriate glucagon secretion delay gastric emptying and thus delays glucose absorption reduces appetite and may contribute to a 1-2kg weight loss Denosumab (Prolia): an alternative for Rx of postmenopausal osteoporosis a human IgG2 monoclonal antibody that targets the RANKL (receptor activator of nuclear factor kappa B ligand). this inhibition prevents the formation, function and survival of osteoclasts and thus decreases bone resorption and bone l...
Source: Oz E Medicine - emergency medicine in Australia - Category: Emergency Medicine Authors: Tags: new drugs Source Type: blogs