Week 8: Alpha-Glucosidase Inhibitors (AGIs) and Selective Sodium Glucose Cotransporter 2 Inhibitors (SGLT2) - affect the flow of sugar in the body w/o affecting insulin

Question 1

AGIs - Acarbose (Precose) MOA

Answer 1

• inhibits carbohydrate absorption in small intestine
  = delay carb absorption = delay glucose absorption

Does not cause hypoglycemia
- weight negative

Question 2

AGIs (Acarbose/Precose) ADRs

Answer 2

• severe GI distress

Question 3

AGIs contraindications

Answer 3

• bowel diseases (IBS, increased risk of bowel obstruction)

- bowel obstruction

Question 4

Acarbose (Precose) patient education

Answer 4

• take with 1st bite of meal

Question 5

SGLT-2s “-flozins” (Invokana, Jardiance, Farxiga) MOA

Answer 5

• inhibits SGLT2 enzyme in the kidney, blocking the reabsorption of glucose in the kidneys - increased secretion of sugar in the urine - works like a diuretic
  Does not cause hypoglycemia - weight negative (H2O loss)

Question 6

SGLT-2s ADRs

Answer 6

• UTI
• genital fungal infections
• hypotension / dehydration
• hyperkalemia
• bladder CA
• increased risk of amputation

Question 7

SGLT2s “-flozins” contraindications

Answer 7

• severe renal impairment

Question 8

SGLT2s counseling points

Answer 8

• black box (potential) - BKA, bladder CA, Fournier gangrene