医学课件_《医用基础药理学》_5.ppt

Chapter 32 Agents used to treat Thyroid diseases Jihong Yao Secretion of Thyroid hormones Regulation of Thyroid Function Actions of Thyroid hormones Pharmacokinetics of insulin Intravenously injected insulin has a T1/2 of less than 9 minutes. The major site of catabolism is the liver, where 50 percent is destroyed in a single passage. it can not be taken orally but must be administered parenterally. Pharmacological effects of Insulin Insulin influences carbohydrate, fat and protein metabolism It lowers the concentration of glucose in blood by stimulating synthesis of glycogen stimulating glycolysis （糖酵解） inhibiting gluconeogenesis (糖异生）and glycogenolysis（糖原分解） It also stimulates RNA, DNA and protein synthesis and is essential for growth. Insulin preparations Short-acting insulin (regular insulin, duration, 5-6 hr） Intermediate-acting insulin （ insulin zinc suspension, duration, 12-16hr） Long-acting insulin （protamine zinc insulin, duration, 24-36hr） ? Theraputic applications of Insulin IDDM (insulin-dependent diabetes mellitus) Gestational diabetes Diabetic ketoacidosis (酮症酸中毒） Hyperosmolar coma （高渗昏迷） ? Adverse reactions of Insulin Hypoglycemia Insulin allergy and Insulin resistance Lipoatrophy and Lipohypertrophy Insulin edema Oral hypoglycemic agents Sulfonylureas 磺酰脲类 Tobutamide 甲苯磺丁脲 Chlorpropamide氯磺丙脲 Glipizide 吡磺环己脲 Pharmacological properties of Sulfonylureas Increase of insulin release from pancreatic B cell Reduction of serum glucagon concentration Increase in numbers of insulin receptors Antidiuretic effect Therapeutic applications of sulfonylureas NIDDM whose pancrease still has capacity to produce insulin, and who can not be treated with diet alone. Chlorpropamide ，which promotes ADH release, possesses antidiuretic effect and is used to treat diabetes insipidus (尿崩症). Adverse reaction