胰岛素及口服降糖药21279ppt课件.ppt

Insulin action enhancer Clinical use Use in type 2 diabetes as monotherapy or in combination with a biguanide. Insulin action enhancer pharmacokinetics metabolized through the hepatic cytochrome P450 system, and their induction of different pathways may affect the bioavailability of other medications such as oral contraceptives. Insulin action enhancer Adverse effect An adverse effect common to all the agents is mild anemia. Edema, hypoglycemia. Insulin and oral hypoglycemic drugs General considerations Insulin Insulin action enhancer Oral hypoglycemia agents Oral hypoglycemia agents Classification Pharmacokinetics Pharmacodynamics Oral hypoglycemia agents Classification Sulfonylureas Biguanides ?-glucosidase inhibitors Oral hypoglycemia agents Sulfonylureas First-generation sulfonylureas Second-generation sulfonylureas Third-generation sulfonylureas Not only decrease blood glucose level but also improve the function of blood platelet Gliclazipe, 格列齐特, 达美康 Gliquidone, 格列喹酮 The more efficacious, the fewer adverse effects than first-generation Glibenclamide, 格列本脲，优降糖 Glipizide, 吡磺环己脲 Glimepiride, 格列美脲 Well absorbed, rapidly or slowly metabolized in the liver, t1/2=4-5 or 32 hours, excretion by kidney Tolbutamide, D860 甲苯磺丁脲 Chlorpropamide, 氯磺丙脲 Oral hypoglycemia agents Pharmacokinetics Well absorption orally administration, high blood protein binding rate, metabolism in the liver, metabolized and original production excretion by kidney, Oral hypoglycemia agents Pharmacodynamics Mechanism Effects Clinical use Adverse effects Oral hypoglycemia agents Mechanism Insulin release from pancreatic βcells Reduction of serum glucagon concentrations Potentiation of insulin action on target tissues. Oral hypoglycemia agents Effects Decrease blood glucose level Promote ADH secretion and enhance its effects Decrease the function of blood platelets Oral hypoglycemia agents Clinical use used in the treatment of patients who have non-insu