Glucosidase Inhibitors

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Chapter: Essential pharmacology : Insulin, Oral Hypoglycaemic Drugs and Glucagon

Acarbose : It is a complex oligosaccharide which reversibly inhibits αglucosidases, the final enzymes for the digestion of carbohydrates in the brush border of small intestine mucosa.


GLUCOSIDASE INHIBITORS

 

Acarbose

 

It is a complex oligosaccharide which reversibly inhibits αglucosidases, the final enzymes for the digestion of carbohydrates in the brush border of small intestine mucosa. It slows down and decreases digestion and absorption of polysaccharides and sucrose: postprandial glycaemia is reduced without increasing insulin levels. Regular use tends to lower Hb A1c, body weight and serum triglyceride. These beneficial effects, though modest, have been confirmed in several studies. Further, the stopNIDDM trial (2002) has shown that longterm acarbose treatment in prediabetics reduces occurrence of type 2 DM as well as hypertension and cardiac disease. In diabetics, it reduces cardiovascular events.

 

Acarbose is a mild antihyperglycaemic and not a hypoglycaemic; may be used as an adjuvant to diet (with or without a sulfonylurea) in obese diabetics. Dose 50–100 mg TDS is taken at the beginning of each major meal. It is minimally absorbed, but produces flatulence, abdominal discomfort and loose stool in about 50% patients due to fermentation of unabsorbed carbohydrates.

GLUCOBAY 50, 100 mg tabs, ASUCROSE, GLUCAR 50 mg tabs.

 

Miglitol is similar to acarbose, and is more potent in inhibiting sucrase.

 

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