You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information.
What is A alpha-glucosidase inhibitor is? and explain in detail?
Ans. b (Maglitol) (Ref. Harrison medicine 17th ed. Table 383-11; KD Tripathi, Pharmacology, 5th ed., 252)ORAL HYPOGLYCEMICS# Sulfonylureas : Tolbutamide, chlorpropamide, glibenclamide, glipizide, gliclazide, glimepiride# Biguanides : Phenformin and metformin.# Meglitinide analogues : Repaglinide, nateglinide# Thiazolidinediones : Rosiglitazone, pioglitazone.# Alpha-glucosidase inhibitor : maglitol, acarbose.GLUCOSE-LOWERING THERAPIES FOR TYPE 2 DIABETESClass of anti-diabetic and ExamplesMechanism of ActionAgent-Specific AdvantagesAgent-Specific DisadvantagesContraindications/ Relative ContraindicationsORALBiguanidesMetforminHepatic glucose production, weight loss, glucose, utilization, insulin resistanceWeight lossLactic acidosis, diarrhea, nauseaSerum creatinine >1.5 mg/dL (men) >1.4 mg/dL (women), CHF, radiographic contrast studies, seriously ill patients, acidosisalpha-Glucosidase inhibitorsAcarbose, Maglitol|Glucose absorptionReduce postprandial glycemiaGl flatulence, liver function testsRenal/liver diseaseDipeptidyl peptidase IV inhibitorsSitagliptinProlong endogenous GLP-1 actionDoes not cause hypoglycemia Reduce dose with renal diseaseInsulin secretagogues-- Sulfonylurea-first generation: Chlorpropamide, Tolazamide, Tolbutamide Sulfonylurea--second generation: Glimepiride, Glipizide, Glipizide (extended release), Glyburide, Glyburide (micronized)|Insulin secretionLower fasting blood glucoseHypoglycemia, weight gainRenal/ liver diseaseInsulin secretagogues-- nonsulfonylureasRepaglinideNateglinide| Insulin secretionShort onset of action, lowers postprandial glucoseHypoglycemiaRenal/ liver diseaseThiazolidinedionesRosiglitazone,Pioglitazone| Insulin resistance,| glucose utilizationLower insulin requirementsPeripheral edema, CHF, weight gain, fractures, macular edema; rosiglitazon may increase risk of MlCongestive heart failure, liver diseasePARENTERALInsulinShort-acting,subcutaneousLispro, AspartGlulisine, Regular| Glucose utilization and other anabolic actionsKnown safety profileInjection, weight gain, hypoglycemia Short-acting, inhaledInhaled regular insulinLong-actingNPH, Detemir,Glargine GLP-1 agonistExenatide| Insulin,| Glucagon, slow gastric emptyingWeight lossInjection, nausea, | risk of hypoglycemia with insulin secretagoguesRenal disease, agents that also slow GI motilityAmylin agonistPramlintideSlow gastric emptying, |GlucagonReduce postprandial glycemia, weight lossinjection, nausea, ?risk of hypogly- cemia with insulinAgents that also slow GI motilityMedical nutrition therapy and physical activityLow-calorie, low-fat diet, exercise| Insulin, resistance,| insulin secretionOther health benefitsCompliance difficult, long-term success low