Agonists Exendin-4 (subsequently renamed exenatide, the first FDA approved incretin mimetic), Liraglutide (a longacting DPP-4-resistant GLP-1 receptor agonist), CJC-1131 (a GLP-1 analog engineered for covalent coupling to albumin), Albiglutide (originally referred to as albugon, a recombinant human albumin-GLP-1 protein), ZP10 (an exendin-4 derivative), BIM51077 (subsequently renamed taspoglutide), LY315902 (a DPP-4-resistant GLP-1 analog), LY2428757 (a pegylated GLP-1), LY2199265 (Dulaglutide, an Fc immunoglobulin fusion protein), Semaglutide (a synthetic peptide similar to GLP-1), Lixisenatide (a synthetic peptide similar to exandin-4), and Tirzepatide (LY3298176, a dual agonist of GIP and GLP-1 receptors)
Causes (I GET SMASHED) * I Idiopathic * G Gallstones (most common overall) * E Ethanol (alcohol) * T Trauma * S Steroids * M Mumps and other infections * A Autoimmune pancreatitis * S Scorpion sting (rare) * H Hypertriglyceridemia/Hypercalcemia * E ERCP * D Drugs (e.g., azathioprine, valproate) Clinical Features * Sudden severe epigastric pain radiating to the back * Nausea and vomiting * Epigastric tenderness * Fever * Tachycardia * Abdominal distension * Reduced bowel sounds (ileus) Severe disease: * Hypotension * Shock * Respiratory distress * Oliguria * Confusion Signs * Epigastric tenderness * Guarding * Dehydration * Cullen sign (periumbilical ecchymosis) * Grey Turner sign (flank ecchymosis) Investigations Blood Tests * Serum lipase (preferred
For instance, in a healthy metabolic system, these hormones signal your pancreas to release insulin and prompt your brain to register fullness
Standard protocol: let the Ipamorelin vial and your bacteriostatic water come to room temperature, wipe both stoppers with a 70% isopropyl swab, then inject the water slowly down the side wall of the peptide vial
