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The most common side effects associated with GLP-1 agonists include appetite loss, nausea, vomiting, and diarrhea, which are often more pronounced when starting the medication or increasing the dosage (4)(10)(23)

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Unlike FDA-approved medications, compounded drugs are custom-made to meet an individuals specific needs, which can include altering dosages or formulations that are not available commercially

This is the frequently referenced RV spiral The primary step in management of RV cardiogenic shock should be to identify and reverse the primary etiology While patients in acute RV failure may respond well to therapies such as fluid resuscitation, inotropes and vasopressors, or inhaled nitric oxide, patients with chronic RV failure (such as in our case) are more likely to have structural defects driving their decompensation Chronic RV failure can result from etiologies related to preload (ASD, tricuspid and pulmonic insufficiency), afterload (pulmonic or pulmonary artery stenosis, pulmonary vascular disease, and left heart disease) or contractility (RV myopathy or ARVC)