Hello friends welcome to I am exploration in this video you will learn 8 clinical facts about Manjaro also known as there is appetite for an in-depth summary make sure to check out our prior video link in the description below my name is Sana I'm a boat certified Internal Medicine physician I'm working as a primary care physician let's begin starting with the mechanism of action this appetite is a novel dual gip1 receptor that is glucose dependent insolinotropic polypeptide receptor and glp-1 receptor that is glucagon like peptide 1 receptor agonis it enhances first and second phase insulin
secretion reduces glucagon levels both in a glucose dependent manner it slows gastric Mt and decreases food intake fact number two indications of Manjaro it is used as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes it is not indicated for use in patients with type 1 diabetes it has also not been studied in patients with the history of pancreatitis with excellent weight loss results in clinical trials it is anticipated that Manjaro is likely to be approved for weight loss in near future moving on to the third clinical aspect
how to administer Manjaro it is injected subcutaneously in the abdomen thigh or upper arm once weekly any time of the day with or without meals one can rotate the injection site with each dose let's discuss the dosing the recommended starting dose is 2.5 milligrams injected subcutaneously once a week the dose is meant for treatment initiation and not foreign after four weeks the dose can be injected to 5 milligrams once a week if additional glycemic control is needed the dose can be increased in 2.5 milligrams increments after the first four weeks on the current dose the
maximum dose is 15 milligrams subcutaneously once a week moving on to those adjustments no dose adjustment is required in geriatric patients for renal or hepatic impairment no dose adjustment is recommended for patients with severe gastrointestinal adverse effects like vomiting diarrhea renal function should be monitored closely when initiating or escalating doses of mancharo some of the common adverse reactions of Montero include nausea vomiting diarrhea decreased appetite constipation and abdominal pain are you finding this information useful support me by clicking the like button I appreciate it moving on let's go over some warning and precautions first is
thyroid cell tumor this appetite caused dose-dependent and treatment duration dependent increase in the incidence of thyroid C cell tumors in two-year studies in rats human relevance of this finding has not been determined it is unknown if mungero causes thyroid cell tumors in humans Manjaro is contraindicated in patients with personal or family history of medullary thyroid carcinoma or in patients with multiple endocrine neoplasia type 2. there is a higher risk of pancreatitis with monjaro use when used in combination with insulin or sulfonylurea Manjaro can increase the risk of hypoglycemia therefore consider reducing the dose of insulin
and sulfonylurea when starting the patient on Manjaro hypersensitivity reactions may occur with one jaro if hypersensitivity occurs discontinue the treatment Manjaro may cause nausea vomiting and diarrhea which if severe can increase the risk of acute kidney injury or person chronic kidney disease if severe patient may eventually need hemodialysis Manjaro is not recommended for patients with severe gastroparesis next warning is about diabetic retinopathy rapid Improvement in glucose has been associated with temporary worsening of diabetic retinopathy patients with a history of diabetic retinopathy should be monitored for progression patients should be monitored for signs and symptoms of
acute gallbladder disease like cholecystitis moving on to drug drug interactions as discussed before mancharo can increase the risk of hypoglycemia when used with sulfonylurea or insulin Manjaro can also delay the gastric emptying therefore impacting the absorption of other oral medications patients on Warfarin should be monitored closely patients should be advised to switch to a non-oral contraceptive method or add a barrier method for four weeks after initiation or four weeks after each dose escalation the non-oral contraceptives are not affected by monjero this brings us to the end of our discussion for an in-depth summary make sure
to check out our prior video also check out the disclaimer in the description below we are building something worthwhile at IM exploration for more actionable insights make sure to subscribe to our Channel we wish you all the happiness and success until next time keep learning and keep growing