Alpha glucosidase inhibitora Flashcards
What are the two drugs in the agi family
Acarbose (precose)
Miglitol (glyset)
Who are good candidates for agi
T2 dm, dyslipidemia,
Obesity, significant post prandial hyperglycemia
Are agi used as monotherapy
No because they do not lower a1c
What are the doses for agi?
Start 25 mg TID. Take with firat bite of meal. Max dose 100. Increase while gi permits
How do agi work?
Antihyperglycemia agents.
Inhibit alpha glucosidase enzymes (maltase, isomaltase, glucomylase, sucrase) in brush border of small intestine and pancrratic alpha amylase leading to reduction in carb mediated post prandial blood glucose elevation. These enzymes hydrolyze di/ti/oligo saccharides and turn them into glucose.
The enzyme inhibition reduces rate of carb digestion of starches and absorption of glucose
How do you initatiate agi meds
Low doses to decrease gi upset.
How do you treat a low with combination therapy if agi plus a sulf or insulin
Because agi blunt digestion of of complex sugars to glucose, oral sugar sources other than lactose (milk) or glucose (glucose tabs) shouldnt be used
Contraindications of agi
Ibd, colonic ulceration, chronic intestinal disorders, obstructive bowel disorders
Cirrhosis
CR >2
Side effecta of agi
Gi effects during initiation of therapy
Doarrhea, flatulence, abdominal pain. Can take several weeks to go away. Improved with slow titration
How do you monitor on agi
2 hr post prandial
What should you test every 3 mo
Serum transaminase for liver toxicity
What shoukd patients do after eating to prevent buildup of fermenting gas?
Be actice
