第10章利尿药及.pptVIP

药物化学Medicinal chemistry 第十章 利尿药及合成降血糖药 第十章 利尿药及合成降血糖药 口服降血糖药 利尿药 第一节 口服降血糖药 Diabetes, chronic disorder of glucose (sugar) metabolism caused by inadequate production or use of insulin, a hormone produced in specialized cells (beta cells in the islets of Langerhans) in the pancreas that allows the body to use and store glucose. 糖尿病：胰岛素分泌不足，糖代谢异常。 I 型糖尿病－胰岛素依赖型（原发性糖尿病） II型糖尿病－非胰岛素依赖型糖尿病 磺酰脲类降糖药 甲苯磺丁脲 格列本脲 盐酸二甲双胍（Metformin hydrochloride） Mechanism of Action Metformin is an antihyperglycemic agent which improves glucose tolerance in patients with type 2 diabetes, lowering both basal and postprandial plasma glucose. Its mechanisms of action are different from other classes of oral antihyperglycemic agents. Metformin decreases hepatic glucose production, decreases intestinal absorption of glucose, and improves insulin sensitivity by increasing peripheral glucose uptake and utilization. INDICATIONS AND USE Metformin hydrochloride, as monotherapy, are indicated as an adjunct to diet and exercise to improve glycemic control in patients with type 2 diabetes. It may be used concomitantly with a sulfonylurea or insulin to improve glycemic control in adults. 第二节 利尿药 Diuretics Diuretic, drug used to increase urine formation and output. Diuretics are prescribed for the treatment of edema (the accumulation of excess fluids in the tissues of the body), which is often the result of underlying disease of the kidneys, liver, lungs, or heart (e.g., congestive heart failure). They are also used to treat hypertension (high blood pressure) and glaucoma. They act on the kidneys, modifying the absorption and excretion of water and electrolytes such as sodium and potassium. 呋塞米 Furosemide INDICATIONS AND USAGE Edema: ?? for the treatment of edema associated with congestive heart failure, cirrhosis of the liver, and renal disease. Hypertension: ?? for the treatment of hypertension alone or in combination with other antihypertensive agents. 氢氯噻嗪 Hydrochlorothiazide INDICATIO