Treatment Options for Patients with Type 2 diabetes - Prescribing Information PLEASE CHECK FULL SPECIFIC PRODUCT CHARACTERISTICS FOR MORE DETAILED AND CURRENT INFORMATION: http://www.medicines.org.uk/emc/please Monthly Cost Contraindications Cautions and monitoring requirements Advantages Disadvantages Metformin Stop if eGFR <30 Use with caution if eGFR <45 Stop in severe acute illness e.g.
sachets when patient has swallowing difficulties.
Sulphonylureas Long acting: Glibenclamide
Severe renal impairment glibenclamide in the elderly, use a
Shorter acting: Glimepiride Gliclazide Tolbutamide Glipizide Treatment Options for Patients with Type 2 diabetes - Prescribing Information PLEASE CHECK FULL SPECIFIC PRODUCT CHARACTERISTICS FOR MORE DETAILED AND CURRENT INFORMATION: http://www.medicines.org.uk/emc/please Monthly Cost Contraindications Cautions and monitoring requirements Advantages Disadvantages Glitazones
prior initiation in all patients. Do not
Cardiac failure or history any other evidence of liver disease.
Pioglitazone and should be continued only if the patient shows a reduction of at least 0.5% in HbA1c in 6 months. This should be explained to the patient at initiation.
Treatment Options for Patients with Type 2 diabetes - Prescribing Information PLEASE CHECK FULL SPECIFIC PRODUCT CHARACTERISTICS FOR MORE DETAILED AND CURRENT INFORMATION: http://www.medicines.org.uk/emc/please Monthly Cost Contraindications Cautions and monitoring requirements Advantages Disadvantages SGLT inhibitors
status (e.g. physical examination, BP measurements,) and electrolytes
in blood pressure, which may be more pronounced in patients with very high blood glucose concentrations.
Experience in heart failure, NYHA class I-II is limited, and there is no experience in clinical studies with dapagliflozin in NYHA class III-IV.
Dapagliflozin has not been studied in combination with glucagon-like peptide 1 (GLP-1) analogues
A lower dose of insulin or an insulin secretagogue may be required to reduce the risk of hypoglycaemia when used in combination with dapagliflozin
Treatment Options for Patients with Type 2 diabetes - Prescribing Information PLEASE CHECK FULL SPECIFIC PRODUCT CHARACTERISTICS FOR MORE DETAILED AND CURRENT INFORMATION: http://www.medicines.org.uk/emc/please Monthly Cost Contraindications Cautions and monitoring requirements Advantages Disadvantages Gliptins inhibitors) Sitagliptin: Pancreatitis – rare, spontaneous
impairment and to 25mg reports of acute pancreatitis, inform
Janumet®: only use in Vildagliptin: Monitor liver function Vildagliptin: Sitagliptin: Vildagliptin: - do not use in hepatic Eucreas®: do not use in patients with CrCl<60 ml/min Treatment Options for Patients with Type 2 diabetes - Prescribing Information PLEASE CHECK FULL SPECIFIC PRODUCT CHARACTERISTICS FOR MORE DETAILED AND CURRENT INFORMATION: http://www.medicines.org.uk/emc/please Monthly Cost Contraindications Cautions and monitoring requirements Advantages Disadvantages Saxagliptin: Saxagliptin: Saxagliptin: - dual therapy –with
metformin or a
sulphonylurea or a
+sulphonylurea ( not -as combination Komboglyze®: - do not use in hepatic DPP-4 inhibitors should be Linagliptin▼: continued only if the patient shows a reduction of at Jentadueto®▼: least 0.5% in HbA1c in 6 months. This should be explained to the patient at initiation.
product Jentadueto®▼ Treatment Options for Patients with Type 2 diabetes - Prescribing Information PLEASE CHECK FULL SPECIFIC PRODUCT CHARACTERISTICS FOR MORE DETAILED AND CURRENT INFORMATION: http://www.medicines.org.uk/emc/please Monthly Cost Contraindications Cautions and monitoring requirements Advantages Disadvantages
Exenatide(Byetta®)▼ £68.24
In patients taking Byetta®▼and
weekly: Bydureon®▼
disease (exenatide▼).
Liraglutide(1.8mg but not recommended
with liraglutide in New York Heart exenatide▼. Liraglutide: only
-do not use exenatide▼ if Reduction of dose of concomitant
Exenatide▼ and Lixisenatide▼ Bydureon®▼ and (BMI) ≥ 35 kg/m2 in Lixisenatide▼ if
liraglutide▼ if <60ml/min. require careful clinical monitoring or
Dual Therapy: Continue therapy if 1% HbA1c reduction at 6 months. (Please explain to the patient at initiation.) Triple Therapy: GLP-1s should be continued only if there is a reduction of at least 1.0% in HbA1c AND a weight loss of at least 3% of initial body weight, at 6 months. (Please explain to the patient at initiation)
US sonography in renal transplant: what role? Our experience in recent years, together with the literature of the same period, allows us to state that, from the early seventies (1), when our radiology colleagues were the first to undertake the US study of renal transplant, to these days, the technology has undergone fascinating developments and US has, at the same time, experienced a sort of “
MEGABACTERIA - A REVIEW OF THE LITERATURE By Claire Talltree, MSW Page 1 MEGABACTERIA A REVIEW OF THE LITERATURE By Claire Talltree, MSW Note: no portion of this article shall be reproduced introduced goldfinches in Victoria, Australia, and without the prior consent of the author. some suspect that it has in fact been there a longtime but unrecognized. Megabacteria was recordedin the