Directory → Metaboliki → Gipoglikemicakie synthetic and other means
This page is translated automatically with a help of Google Translate
Gipoglikemicakie synthetic and other means
The groupAlong with insulin, drugs which are suitable only for the injection of a number of synthetic compounds that have gipoglikemicescoe Effects used for the treatment of diabetes mellitus and effective when administered. The mechanism of these substances are substantially different from human insulin.
Oral antidiabetics preparations divided into three main groups : sulfonamidov derivatives, and biguanida alfa-glukozidaz inhibitors.
The derivatives sulfonamidov was primarily due to the stimulation beta-kletok pancreas, accompanied by the mobilization and the increased release of endogenous insulin. The main prerequisite for the display of their effect is the existence of the pancreas functionally active beta-kletok. They think that they are "close" (antagonists) potassium channels beta-kletok reduce output potassium in vnecleterne space, and stimulate the release of insulin. In addition, sulfonamida increasing number of инсулинчувствительны х receptors kletkah-misheniah.
Biguanida, unlike derivatives sulfonamidov not stimulate the secretion of insulin beta-kletkami pancreas. Their effect is largely determined glukoneogeneza oppression in the liver (including glikogenoliza), and increased peripheral glucose utilization. They also undermine inachtivirovnie insulin.
Oral antidiabetics drugs are the principal means drug therapy insulinnezawisimogo diabetes (type II), and are usually assigned to patients over 35 years of age without ketoatsidoza deficit nutrition, or complications related illnesses requiring immediate insulinoterapii.
Drugs group sulfonamidov not recommended for people with the correct diet daily need for insulin exceeds 40 U. Also not appoint sick severe diabetes mellitus (when expressed beta-kletok deficiency) if ketoza or diabetic coma in history, the io above 13.9 mmol / l (250 mg%) and prandial glukozurii high in the face of trauma.
Translation of treatment drugs sulfonamidov diabetes mellitus in insulinoterapii possible, When violations of hydrocarbons offset in insulin doses less than 40 U / sut. When insulin doses up to 10 U / day can skip right to be treated sulfonamidov derivatives.
Prolonged use of derivatives sulfonamidov can cause the development of resistance to overcome that allows combination therapy with insulin therapy. For diabetes type I, a combination of drugs with insulin sulfonamidnami funds help to reduce the daily need for insulin and helps the course of the disease, including slowed progression of retinopathy, in part because of a angioprotectivna activity sulfonamidov derivatives (especially II generation). However, there are indications of their potential aterogennoe effect.
Gipoglikemicakie sulfonamida classes of drugs I and II generation. Some representatives of these groups differ in activity and endurance. Thus, daily intake of drugs I generation tolbutamida and hlorpropamida - reaches 2 and 0.75 g and preparations II generation glibenklamida - 0.02 g glikvidona - 0,06-0,12 and textiles II generation is usually best transferred patients.
Using sulfonamidnykh gipoglikemicakih drugs, it should be noted that anti sulfanilamida, combined group dikumarina, butadion, ethionamide, and salicilata, tetratziklin, levomicetin, ziklofosfan impeding their metabolism and enhance the effectiveness of (possibly gipoglikemii development). Sulfonamida increase of intolerance and alcohol, presumably because of the delay oxidation of acetaldehyde.
All sulfonamidnye gipoglikemicakie drugs should be taken for one hour prior to delivery, that contributes to a decrease expressed postprandialna (after eating) fast.
Gipoglikemicakie biguanida buformin (glibutid), zinc (glukofag), and others have also taken diabetes type II. Regarding the group holding lipogenez increase lipolysis, reduced appetite. In some cases, their use is accompanied by a decrease in cholesterol and triglycerides in the serum. Biguanida can be applied in combination with insulin with resistance to it. The combination of these products with derivatives sulfonamidov shown in the cases where they do not provide the full address of metabolism. Biguanida can cause development molernkislogo azidoza (acidosis), which restricts the use of certain drugs that group.