Pain Management Medical Expert

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Case Analysis – Personal Injury – Deposition & Trial Preparation

Table of Contents

Complex Regional Pain Syndrome

Spinal Cord Stimulation

Percutaneous Discectomy

GLP - 1 Receptor Anagonist

Neuropathic Pain

Cervical Radiculopathy

GLP-1 Receptor Antagonist

Glucagon-like peptide-1 (GLP-1) receptor agonists are a class of medications that mimic the action of glucagon-like peptide-1, a hormone that stimulates insulin secretion in response to meals, inhibits glucagon release, and slows gastric emptying. These drugs are used to improve blood sugar control in adults with type 2 diabetes and help treat obesity. Commonly known GLP-1 receptor agonists include trade names such as Ozempic (semaglutide), Byetta (exenatide), Victoza (liraglutide), Trulicity (dulaglutide), and Rybelsus (oral semaglutide). They work by binding to GLP-1 receptors on pancreatic beta cells, thereby enhancing insulin secretion and suppressing the release of glucagon, which helps lower blood glucose levels.

The benefits of GLP-1 receptor agonists include significant reductions in HbA1c levels, which measure long-term blood glucose control, and weight loss, as these medications can decrease appetite and promote satiety. Additionally, some GLP-1 receptor agonists have been shown to have cardiovascular benefits, reducing the risk of major adverse cardiovascular events in patients with type 2 diabetes and established cardiovascular disease. However, there are risks associated with these medications, including gastrointestinal side effects such as nausea, vomiting, and diarrhea. There is also a risk of pancreatitis and, rarely, kidney injury or thyroid C-cell tumors, which necessitate careful patient selection and monitoring.

Before surgery and receiving anesthesia medications, GLP-1 receptor agonists are typically held due to the risk of slowed gastric emptying, which can increase the likelihood of aspiration during anesthesia. The recommended hold time varies depending on the specific medication. According to the American Society of Anesthesiologists (ASA), patients taking GLP-1 receptor agonists should stop taking them at least 24 hours before the procedure. For longer-acting agents, such as those with a weekly dosing schedule, it may be necessary to hold the drug for several days to weeks prior to surgery. This precaution helps ensure that the stomach is empty, reducing the risk of aspiration and improving the safety of anesthesia administration. It is crucial for patients to discuss their medication management with their healthcare providers well in advance of any surgical procedure.