Pregnancy and breastfeeding : Inform your doctor if you are pregnant, breastfeeding, or planning to become pregnant soon
Regulatory and Ethical Concerns In the United States, telehealth prescribing falls under a mixture of state and federal regulations that determine the licensure of clinicians, the prescribing authority and pharmacy activities
Contamination and incorrect dosing are serious risks
Key Points The incretins glucagon-like peptide 1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) are gut-derived hormones that potentiate insulin secretion and contribute to glucose metabolism through a wide range of physiological actions Inhibitors of the incretin-inactivating enzyme dipeptidyl peptidase 4 (DPP-4) and DPP-4-resistant injectable GLP-1 receptor agonists have been developed for the treatment of hyperglycaemia in type 2 diabetes mellitus (T2DM) GLP-1 and other gut-derived hormones might directly and/or indirectly regulate electrolyte and fluid homeostasis by influencing feeding and drinking behaviour as well as electrolyte transport in the kidneys and gastrointestinal tract GLP-1 receptor (GLP-1R) agonists and DPP-4 inhibitors increase natriuresis in T2DM, possibly through overlapping and distinct mechanisms, and might slightly improve renal haemodynamics in the setting of diabetes-related glomerular hyperfiltration Incretin-based therapies seem to directly influence renal physiology and have indirect metabolic and haemodynamic actions that might reduce renal risk in T2DM
268 ZhouM.SunZ.DingM.LogachevaM
Microdosing tirzepatide often uses improvised charts and compounded vials increasing risk of inaccurate dosing contamination and unpredictable results
