Who is metformin contraindicated in? What is the prototype a-glucosidase inhibitor? What is the mechanism of acarbose? What is true of the action of arcabose and other drugs? What are the d-d interactions of arcabose? What are the side effects of acarbose? What aer the contraindications of acarbose? What is true of hypoglycemic incidences with patient on acarbose? What is the prototype glinide? What is the effect of the glinides?

1. Who is metformin contraindicated in?

can cause lactic acidosis in renal or hepatic impaired patients (creatinine clearance , 40 mg/ml)

2. What is the prototype a-glucosidase inhibitor?

Acarbose

3. What is the mechanism of acarbose?

oral inhibitor of alpha glucosidase (disaccharidase) blocks the digestion of complex carbohydrates in intestines and prevents postprandial rise of blood glucose

4. What is true of the action of arcabose and other drugs?

this one acts exclusively in the intestine but there are absorbal versions of the drug like miglitol

5. What are the d-d interactions of arcabose?

additive with sulfonylureas and biguanides

6. What are the side effects of acarbose?

diarrehea and other GI problems
Rare: jaundice with arcabose

7. What aer the contraindications of acarbose?

patients with bowel disease

8. What is true of hypoglycemic incidences with patient on acarbose?

it prevents the breakdown of sucrose, so foods that are directly glucose and don't have to be broken down should be used to counteract the hypoglycemia

9. What is the prototype glinide?

Repaglinide (nateglinide is the other ex.)

10. What is the effect of the glinides?

in the presence of glucose, act to block the ATP - inhibited K+ pumps in the b cells of the pancreas, inducing insulin release