00:01
Our fifth family are the
alpha-glucosidase inhibitors, okay?
These names just keep getting longer and longer.
00:10
But let's start with a fun question.
00:12
What is borborygmus?
All right?
What is borborygmus?
The answer?
Those are those weird
stomach noises and rumbling,
and that's one of the bizarre side
effects of alpha-glucosidase inhibitors.
00:33
So, alpha-glucosidase is an enzyme that breaks
down carbohydrates into monosaccharides.
00:39
So, in a healthy body, that's
what alpha-glucosidase does.
00:43
It's an enzyme.
00:44
And when I eat a carbohydrate, it has to be broken
down into monosaccharides, so I can use it.
00:49
Alpha-glucosidase inhibitors
work in the intestines
and they delay the dietary
carbohydrate absorption.
00:58
So, that's where those weird noises come from.
01:01
Anytime you start messing with the digestive
process, you're going to get some weird things.
01:07
If I have delayed carbohydrates, it's going
to end up with bacterial fermentation.
01:13
Might be another source of
those weird stomach noises.
01:18
So, what do we use these guys for?
Well, we can use them by themselves.
01:22
There's no risk for hypoglycemia.
01:25
Wait a minute.
01:26
What other medications have we discussed
that have a risk of hypoglycemia?
See if you can write that note in your margin now.
01:40
We can also use these with combination therapy,
but now when we add these drugs
in like insulin or sulfonylureas,
because those drugs do have
a risk of low blood sugar,
now your patient is at risk for low blood sugar.
01:55
Now, this is just an extra side for you,
to help you kind of remember,
alpha-glucosidase inhibitors, we make the "G"
and the "I" really big to help you remember,
we can have some liver issues,
those weird stomach noises.
02:09
We can also have problems with iron.
02:12
Now, long-term high-dose therapy, you might
have reversible damage to that liver, okay?
We might be able to fix it once you're off it.
02:19
So, you're going to see that effect,
the problem with your liver,
the higher the dose and your
longer that you're on it.
02:25
Those weird, GI stomach noises, you'll likely
see that in the beginning of the doses.
02:30
So we don't widely use this drug in the United
States, but we wanted you to be aware of it.