α-Glucosidase Inhibitors (AGI)

Question 1

α-Glucosidase Inhibitors (AGI): MOA

Answer 1

• DECREASE breakdown of sucrose & complex carbs in brush border of the small intestine (GI)

Question 2

α-Glucosidase Inhibitors (AGI): Site of Action

Answer 2

• GUT

Question 3

α-Glucosidase Inhibitors (AGI) Drugs

Answer 3

• Acarbose (Precose)

- Miglitol (Glyset)

Question 4

Acarbose: Dosing

Answer 4

• 25mg PO TID

- MDD=50mg PO TID

Question 5

Miglitol Dosing

Answer 5

• 25mg PO TID
• MDD=100mg PO TID

Should be taken with every meal

If they are not eating COMPLEX CARBS, then this is not the choice of drugs

Question 6

α-Glucosidase Inhibitors (AGI): Side effects

Answer 6

Gastrointestinal (worse than metformin)

• Abdominal pain
• Diarrhea
• Flatulence
• Bloating

Question 7

α-Glucosidase Inhibitors (AGI): Contraindications

Answer 7

• Hypersensitivity
• DKA
• Cirrhosis
• Irritable Bowel Syndrome (IBS)
• Crohn’s Disease
• Colonic ulceration
• Intestinal obstruction
• SCr > 2.0

Mostly GI

Question 8

α-Glucosidase Inhibitors (AGI): Precautions

Answer 8

• Impaired renal function

Question 9

α-Glucosidase Inhibitors (AGI): Counseling points

Answer 9

• Start low, go slow
• Take with the first bite of each meal (Skip a meal, skip the dose)

ASK ABOUT GI upset and meal timing

Question 10

α-Glucosidase Inhibitors (AGI): Monitoring

Answer 10

• PPG
• A1c
• GI intolerance

Time to peak effect: 4-6 weeks