胰岛素和口服降血糖药（双语教学）.pptVIP

* * Chapter 35 INSULIN and ORAL HYPOGLYCEMIC AGENTS 胰岛素和口服降血糖药物 Tang Qiang Department of Pharmacology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China Tangqiang_tjmu@ GOODMAN GILMANS THE PHARMACOLOGICAL BASIS OF THERAPEUTICS(the 11th edition) Basic and Clinical pharmacology 面向21世纪教材-----药理学(第二版) References Diabetes Mellitus （糖尿病） Diabetes mellitus (DM) consists of a group of syndromes characterized by hyperglycemia（高血糖）; altered metabolism of lipids, carbohydrates, and proteins（脂质、糖类、蛋白质代谢异常）; and an increased risk of complications(并发症） from vascular disease. Most patients can be classified clinically as having either type 1 or type 2 DM Type 1 DM -------- an extensive and selective loss of pancreatic β cells（胰岛β细胞） and a state of absolute insulin deficiency Type 2 DM -------- A pancreatic b-cell defect（缺陷） and a reduction in tissue sensitivity（敏感性） to insulin Paragraph 1 Insulin Insulin is about 5734 daltons（道尔顿） protein, which contains A and B peptide chains, The A chain usually is composed of 21 amino acid residues, and the B chain has 30 the Physiological and Pharmacological Effects of Insulin lower the concentration of glucose in blood ------ inhibit hepatic（肝脏） glucose production ------ stimulate the uptake and metabolism of glucose by muscle and adipose tissue（脂肪组织） ------ inhibits the hormone-sensitive lipase（脂酶） in adipose tissue and thus inhibits the hydrolysis of triglyceride（甘油三酯） stores The Insulin Receptor and the Insulin Action Cascade The insulin receptor is a large transmembrane glycoprotein（跨膜糖蛋白） composed of two a subunits and two β subunits a subunits ----- Entirely extracellular and contain the insulin-binding domain b subunits ------- Transmembrane proteins that possess tyrosine protein kinase(酪氨酸激酶） activity Classification of Insulins 1. rapid-acting preparation(短效类） Regular insulin may be given intravenously(静