GLP-1 Receptor Agonists [Neurosurgery Wiki]

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====== GLP-1 Receptor Agonists ======

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are a class of drugs used in the management of:
  * Type 2 diabetes mellitus
  * Obesity and overweight
  * Cardiovascular risk reduction

They mimic the action of the GLP-1 hormone, enhancing glucose-dependent insulin secretion and reducing appetite.

===== 🧬 Mechanism of Action =====
  * Stimulates **insulin secretion** (glucose-dependent)
  * Inhibits **glucagon release**
  * **Slows gastric emptying**
  * Promotes **satiety** via CNS pathways

===== 💊 Examples of GLP-1 RAs =====
^ Generic Name     ^ Brand Name(s)         ^ Dosing Frequency       ^
| Exenatide        | Byetta / Bydureon     | BID / Weekly           |
| Liraglutide      | Victoza / Saxenda     | Daily                  |
| Dulaglutide      | Trulicity             | Weekly                 |
| Semaglutide      | Ozempic / Wegovy      | Weekly                 |
| Tirzepatide *    | Mounjaro              | Weekly                 |

  *Tirzepatide is a dual GLP-1/GIP receptor agonist.

===== 📈 Clinical Indications =====
  * Type 2 diabetes mellitus (T2DM)
    * Reduces HbA1c with low hypoglycemia risk
  * Obesity and overweight (with or without T2DM)
    * Significant weight loss, especially with semaglutide and tirzepatide
  * Cardiovascular risk reduction
    * CV benefit shown with liraglutide, dulaglutide, and semaglutide in high-risk patients

===== ⚠️ Common Side Effects =====
  * Nausea, vomiting, diarrhea, constipation
  * Gallbladder disease
  * Pancreatitis (rare but serious)
  * Injection site reactions

===== ❌ Contraindications =====
  * Personal/family history of **medullary thyroid carcinoma (MTC)**
  * **MEN type 2** syndrome
  * History of **pancreatitis** (use with caution)

===== 🔬 Ongoing Research =====
  * Non-alcoholic steatohepatitis (NASH)
  * Cognitive and neurodegenerative disease modulation
  * Multi-agonist therapies (dual/triple incretin agonists)

===== GLP-1 Receptor Agonists in Idiopathic Intracranial Hypertension =====
[[GLP-1 Receptor Agonists in Idiopathic Intracranial Hypertension]].