Course Summary

Semaglutide, a GLP-1 receptor agonist (GLP-1 RA), has transformed the management of Type 2 diabetes, obesity, and cardiometabolic disease. Originally approved for glycemic control, its use has expanded to chronic weight management and emerging applications in heart failure, chronic kidney disease (CKD), and substance use disorders. The pharmacology, clinical efficacy, safety considerations, and evolving therapeutic roles of semaglutide use are explored. Insights into the benefit of semaglutide treatment and specific dosing strategies, adverse effect management, and best practices for clinical care are raised. Through an evidence-based approach, the interprofessional health team is able to optimize treatment outcomes and minimize risks with the use of semaglutide.

Course Format

Homestudy

Course Syllabus

• Introduction
• Pharmacological Profile
  • Mechanism of Action: Physiological Effects, Satiety Signaling and Metabolic Regulation
  • Clinical Significance of Metabolism and Elimination
  • Indications, Dosing, and Administration
  • Dosing and Administration: Type 2 Diabetes Mellitus (T2DM)
  • Dosing and Administration: Cardiovascular Risk Reduction
  • Dosing and Administration: Chronic Kidney Disease Risk Reduction
  • Weight Management for Obesity or Overweight/Comorbidities
  • Metabolic Dysfunction: Steatotic Liver Disease, Steatohepatitis (MASLD/MASH) Investigational Use
  • Geriatric Treatment Guidelines
• Clinical Applications: Primary Indications and Efficacy 
  • Type 2 Diabetes Mellitus
  • Glycemic Control and HbA1c Reduction
  • Treatment Benefit in Heart Failure Cases
  • Treatment Benefit in Chronic Kidney Disease Cases
  • Obesity and Weight Management
  • Semaglutide as Adjunctive Therapy
• Contraindications and Precautions
  • Thyroid C-Cell Tumors
  • Hypersensitivity Reactions
  • Pancreatitis and Severe Gastrointestinal Disorders
  • Mood Changes and Psychiatric Symptoms
  • Ophthalmic Complications
  • Gender Differences
• Drug-Drug Interaction
  • Delayed Gastric Emptying and Absorption of Oral Forms
  • Hypoglycemia Risk with Combination Use
  • GI Risk With Combination Use
• Monitoring and Toxicity
  • Toxicity: Clinical Presentation
  • Clinical Management of GLP-1 RA Overdose
• Clinical Pearls
  • Delayed Gastric Emptying and Absorption of Oral Medications
  • Research on the Unknown Long-Term Impact of Semaglutide Use
  • Insurance Coverage Challenges
  • Orexin and GLP-RAs
  • Ongoing Research and Off-Label Uses of Semaglutide in Neurology and Psychiatry (Alzheimer’s and Parkison’s Disease, Substance Use Disorders)
• Role of the Interprofessional Health Team
• Case Report: HNF1B-MODY and the Role of Semaglutide in Glycemic Control
  • Differential Diagnosis
  • Discussion: Clinical Implications and Future Considerations
• Case Study: Diabetes and Depression
  • Differential Diagnosis
  • Discussion: Monitoring Medical and Mental Health Comorbidity
• Summary

Authors

Richard Daniels, PharmD, BCPS

Richard “Cole” Daniels earned his Doctor of Pharmacy(PharmD) from the Skaggs School of Pharmacy at the University of Montana in 2018. Throughout pharmacy school he completed a 3-year internship at Community Medical Center in Missoula, Montana in which he gained valuable experience in an acute care setting. Cole currently serves as a psychiatric clinical staff pharmacist at the Montana State Hospital. He has over 11 years of pharmacy experience having worked in several settings including retail, acute care, and inpatient psychiatric care. Cole has a diverse set of interests. However, acute care medicine, infectious disease, pain management, and asthma/COPD are a primary focus of his at the Montana State Hospital. He obtained board certification as a certified pharmacotherapy specialist in the Spring of 2022.

Elisabeth Gordon, BScPharm, RPh

Elisabeth Gordon earned her BSc(Pharm) from the University of British Columbia in 2004. After graduation, she worked in community retail pharmacies on Vancouver Island, before returning to her rural hometown of Salmon Arm. In 2016 and 2017, Elisabeth trained with Pallium Canada and Victoria Hospice to enhance her knowledge of end-of-life-care and palliative services. She is a volunteer medical supervisor for T1DOutreach, a peer support platform for adults living with type 1 diabetes, and a member of a Canadian peer support group for adults living with Birdshot Uveitis. Elisabeth enjoys working in a small, fast-paced rural pharmacy where she brings compassion and empathy to her everyday practice.