L30- Antidiabetic Drugs II (α-GIs)

Question 1

α-Glucosidase- mainly (1): MOA

Answer 1

Acarbose:

• inhibits α-glucosidases, competitive inhibitor
• RXN: tri-/di-saccharides —-> glucose
• decreases glucose absorption in SI

Question 2

Acarbose:

• reduces digestion of (1) to minimize (2), deferring it to (3)
• (4) and (5) are reduced as a result
• (6) are the long-term goals

Answer 2

1- starch, disaccharides
2- upper intestinal carbohydrate absorption
3- absorption in the distal SI

4/5- dec postprandial hyperglycemia and hyperinsulinemia
6- reduced HbA1c, FPG

Question 3

Acarbose:

• (1) AEs
• (2) contraindications
• associated with reversible elevation of (3)

Answer 3

1- flatuence, diarrhea, abdominal pain

2- IBS, or any other intestinal issue worsened by gas / distension

3- hepatic enzyme elevation –> periodical liver function monitoring required by acarbose therapy