《利尿药及》PPT课件

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1、药物化学Medicinalchemistry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,chronicdisorderofglucose(sugar)metabolismcausedbyinadequateproductionoruseofinsulin,ahormoneproducedinspecializedcells(betacellsintheisletsofLangerhans)inthepancreasthatallowsthebodytouseandstoregluc

2、ose.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苯磺酰脲基本结构作用机制：刺激胰岛素分泌甲苯磺丁脲磺酰脲类降糖药，刺激胰岛素分泌，甲基易被氧化失活。特点：降糖作用较弱、安全。用途：治疗II型糖尿病。格列本脲磺酰胺基对位引入侧链，脲基末端有脂环或含氮脂环。特点：作用强。代谢产物有活性，肾功能不全慎用（引起低血糖）。用途：用于中、重度II型糖尿病人。盐酸二甲双胍（Metforminhydrochloride）用途：用于治疗II型糖尿病Metforminisexc

3、retedunchangedintheurineanddoesnotundergohepaticmetabolism.Unlikesulfonylureas,metformindoesnotproducehypoglycemiaineitherpatientswithtype2diabetesMechanismofActionMetforminisanantihyperglycemicagentwhichimprovesglucosetoleranceinpatientswithtype2diabetes,loweringbothbasala

4、ndpostprandialplasmaglucose.Itsmechanismsofactionaredifferentfromotherclassesoforalantihyperglycemicagents.Metformindecreaseshepaticglucoseproduction,decreasesintestinalabsorptionofglucose,andimprovesinsulinsensitivitybyincreasingperipheralglucoseuptakeandutilization.INDICA

5、TIONSANDUSEMetforminhydrochloride,asmonotherapy,areindicatedasanadjuncttodietandexercisetoimproveglycemiccontrolinpatientswithtype2diabetes.Itmaybeusedconcomitantlywithasulfonylureaorinsulintoimproveglycemiccontrolinadults.第二节利尿药DiureticsDiuretic,drugusedtoincreaseurineform

6、ationandoutput.Diureticsareprescribedforthetreatmentofedema(theaccumulationofexcessfluidsinthetissuesofthebody),whichisoftentheresultofunderlyingdiseaseofthekidneys,liver,lungs,orheart(e.g.,congestiveheartfailure).Theyarealsousedtotreathypertension(highbloodpressure)andglau

7、coma.Theyactonthekidneys,modifyingtheabsorptionandexcretionofwaterandelectrolytessuchassodiumandpotassium.呋塞米Furosemide磺酰胺类利尿药。IthasbeendemonstratedthatfurosemideinhibitsprimarilythereabsorptionofsodiumandchloridenotonlyintheproximalanddistaltubulesbutalsointheloopofHenle.I

8、NDICATIONSANDUSAGEEdema:forthetreatmentofedemaassociatedwithcongestiveheartfailure