Home Drug Guide Tirzepatide

Drug Guide

Generic Name

Tirzepatide

Brand Names Mounjaro, Zepbound

Classification

Therapeutic: Antidiabetic agent

Pharmacological: Dual GIP and GLP-1 receptor agonist

FDA Approved Indications

  • Type 2 diabetes mellitus

Mechanism of Action

Tirzepatide is a dual incretin receptor agonist that mimics the effects of GIP and GLP-1, leading to increased insulin secretion, decreased glucagon secretion, delays in gastric emptying, and appetite suppression, thereby improving glycemic control.

Dosage and Administration

Adult: Start with 2.5 mg once weekly, titrate up to 15 mg weekly based on glycemic response and tolerability.

Pediatric: Not approved for pediatric use.

Geriatric: Use with caution, starting at lower doses due to potential for renal impairment or other comorbidities.

Renal Impairment: Adjust dose cautiously in severe renal impairment.

Hepatic Impairment: Use with caution; no specific dose adjustment recommended.

Pharmacokinetics

Absorption: Absorbed slowly following subcutaneous injection.

Distribution: Distributed in plasma and tissues, volume of distribution approximately 12 L.

Metabolism: Metabolized via proteolytic cleavage as a peptide. Minimal hepatic metabolism.

Excretion: Excreted primarily via the kidneys as metabolites.

Half Life: Approximately 5 days, allowing for once-weekly dosing.

Contraindications

  • Personal or family history of medullary thyroid carcinoma (MTC) or multiple endocrine neoplasia syndrome type 2.

Precautions

  • Use with caution in patients with a history of pancreatitis. Monitor for gastrointestinal side effects.

Adverse Reactions - Common

  • Nausea (Common)
  • Diarrhea (Common)
  • Vomiting (Common)
  • Decreased appetite (Common)

Adverse Reactions - Serious

  • Pancreatitis (Serious)
  • Hypoglycemia (when used with insulin or insulin secretagogues) (Serious)
  • Thyroid C-cell tumors (risks observed in animal studies) (Serious)

Drug-Drug Interactions

  • Insulin or insulin secretagogues (increase risk of hypoglycemia)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor blood glucose levels regularly. Assess for signs of gastrointestinal side effects and pancreatitis.

Diagnoses:

  • Ineffective health management related to medication regimen.
  • Risk for hypoglycemia.

Implementation: Administer once weekly via autoinjector. Educate patient on proper injection technique and storage.

Evaluation: Effective glycemic control and management of side effects.

Patient/Family Teaching

  • Take medication exactly as prescribed.
  • Rotate injection sites.
  • Recognize signs of hypoglycemia and pancreatitis.
  • Report persistent gastrointestinal symptoms or any signs of thyroid tumors.

Special Considerations

Black Box Warnings:

  • Thyroid C-cell tumors observed in animal studies

Genetic Factors: Patients with family history of medullary thyroid carcinoma should not use.

Lab Test Interference: May increase amylase and lipase levels, monitoring recommended.

Overdose Management

Signs/Symptoms: Severe nausea, vomiting, dehydration.

Treatment: Supportive care; no specific antidote. Discontinue tirzepatide and manage symptoms accordingly.

Storage and Handling

Storage: Store unopened autoinjector in refrigerator (36°F to 46°F). After first use, can be stored at room temperature up to 86°F for up to 28 days.

Stability: Stable for specified period at room temperature after first use.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.