GLP-1 Agonists

Semaglutide, liraglutide and exenatide are GLP-1 receptor agonists; tirzepatide acts at GIP as well, so this is not one receptor even inside one family. They potentiate insulin release only when glucose is up, slow gastric emptying, and reduce appetite through central signalling — the appetite effect is why most people in this tree meet them at all.

Two consequences are easy to miss. Slowed gastric emptying changes when an oral dose of anything else arrives, so onset judged by feel is unreliable, and a stomach that has not emptied matters to anything that suppresses airway reflexes. And the gastrointestinal effects are not incidental: nausea and vomiting are common enough that antiemetics get co-used, with dehydration behind them. Compounded and grey-market vials are widespread in this family, and for those neither contents nor sterility is established.