The document discusses alpha-glucosidase inhibitors, which work by reducing postprandial glucose levels in both normal and diabetic patients, creating an insulin-sparing effect. They have a small efficacy and do not cause hypoglycemia even in overdose. Acarbose has an oral bioavailability of 2% while miglitol is over 90%, and miglitol is over 90% eliminated by the kidneys. They are contraindicated in inflammatory bowel disease and gastrointestinal conditions made worse by gas or bloating, and used to treat type 2 diabetes as monotherapy or in combination with other drugs, or as monotherapy in elderly patients or those with postprandial hyperglycemia.

2. MECHANISM
OF ACTION

3. MECHANISM
OF ACTION

4. PHARMACOLOGICAL EFFECTS
•POSTPRANDIAL GLUCOSE LEVELS IS REDUCED BOTH IN NORMAL
AND DIABETIC SUBJECTS, SO CREATING AN INSULIN SPARING
EFFECT.
•THE EFFICACY OF THE DRUGS IS SMALL.
•HYPOGLYCEMIA DOES NOT OCCUR EVEN IN OVERDOSAGE.

5. PHARMACOKINETICS
•ORAL BIOAVAILABILITY: ACARBOSE 2%; MIGLITOL >90%
•ELIMINATION: MIGLITOL > 90% BY THE KIDNEY

6. CONTRA-INDICATIONS AND CAUTIONS
•INFLAMMATORY BOWEL DISEASE
•GASTROINTESTINAL CONDITIONS WORSENED BY GAS OR DISTENSION
•RENAL DISEASE

7. THERAPEUTIC USES
•TYPE II DIABETES AS MONOTHERAPY OR IN COMBINATION WITH SULFONYLUREAS OR
INSULIN.
•AS MONOTHERAPY IN ELDERLY PATIENTS OR IN PATIENTS WITH PREDOMINANTLY
POSTPRANDIAL HYPERGLYCEMIA.
•NOTE: IF HYPOGLYCEMIA OCCURS WHEN ADMINISTERED WITH INSULIN OR
SULFONYLUREAS, ORAL ADMINISTRATION OF SUGARS OTHER THAN GLUCOSE IS
INEFFECTIVE.

8. ALPHA GLUCOSIDASE INHIBITORS