Dr. Daniel S. Tang - Presenter

HANP Meeting May 12, 2015

Dr. Daniel S. Tang - Presenter

Sponsor: AztraZeneca

LECTURE NOTES

Incretin effect

1. Mediates insulin surge effect

2. Glucagon effect increases

3. Increased appetite due to loss of Excretion system

4. Rapid gastric emptying

BYDUREON

INDICATED: DM2

SAME molecule as byetta

CONTRAINDICATIONS:

1. Medullary thyroid cancer (rare)

2. Pancreatitis associated with increased risk of pancreatitis

3. Renal impairment GFR<30

4. Diabetic gastroparesis

PHYSIOLOGY

GLP 1 is naturally produced in intestine

1. Enhances secretion of insulin

2. Suppress glucagon

3. Slow GI emptying

4. Suppress GLP1 reduce food intake

BYDUREON GLP1 agonist

1. Restores the physiology

2. GLP1 given to diabetics restores euglycemia

3. 3 year study N 456 A1c of 7-11, on stable on MET and SU, DM 7.9 years. RCT to Bydureon vs. Lantus treatment arm 10 units AM, if FBS >100 add 2 units to standard dose. A1C reduction A1C reduction better with Bydureon at 6 months and at 3 years. Bydureon lost 5.5 lbs at 3 years. Less hypoglycemia

4. SE: NV, diarrhea, constipation, injection site issues

5. BYDUREON VS> BYETTA

- Better A1c and weight loss with bydureon

- less nausea with bydureon

6. INR could be affected on patients taking warfarin, not approved for pregnant women

JOHNNY ROLLINS, President Elect

1. Announcements

2. Scholarship committee members announced

3. 10 applicants for scholarships this year

4. Next set to be given November 2015

5. $1,000K for NP, DNP student

6. Awardees:

Kristine Clements

Blanca Barrera

Carylin Holsey

7. November 7, 2015 Annual Conference

SARAH WOODS

1. Announcement

2. Conference for Psychiatric APNs June 6, 2015 will include topics in geriatric care and

ethics

CARLOS BUFORD

1. CROSSING THE BARRIERS OF SPIRITUAL CARE - update on his DNP survey

a) everyone believes spirituality is the right thing to do

b) patients also desire for health care providers to know their spiritual preference

c) Barriers and comparison of 3 groups

ELIZABETH GIGLIONI TNP REPRESENTATIVE
1. 19 days left in the legislative session

2. House bill 2602 is dead - we cannot prescribe for narcotics for patients going home.

Schedule 2

3. We encourage you to join TNP to help advance the cause of nurse practitioners in the

state of Texas

ELECTION OF OFFICERS - RICK ROBERTS

1. NOMINATIONS WILL BE ENDING SOON
2. If interested please let us know

3. Electronic ballots will be going out June 3 - June 9, please vote

4. June 17, 2015 next meeting

Alison Mitchell will be inducted into the AANP fellow

Maryland full practice authority for NPs