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One survey shows about 12% of U.S

Synergistic effects Clinical evidence shows that combining metformin with semaglutide provides stronger benefits, such as better blood sugar control and weight management, than using either medicine alone

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Mechanism of Action: Inhibit Na/K-ATPase intracellular Na Na/Ca exchange intracellular Ca stronger cardiac contraction Vagal tone slow AV node conduction heart rate Effects: Cardiac output Heart rate symptoms of heart failure Examples: Digoxin Digitoxin Clinical Uses: Heart failure with reduced ejection fraction Atrial fibrillation and atrial flutter (rate control) Adverse Effects: Arrhythmias (especially with electrolyte imbalance) GI: nausea, vomiting, diarrhea CNS: confusion, visual disturbances (yellow-green vision) Toxicity risk with hypokalemia, renal impairment, drug interactions Quick Thought Question: How would you monitor a patient for cardiac glycoside toxicity