On the day of the pharmacology exam, I wrote repaglinide as Grindelwald…|Schoolmaster Notes·Concord Eight

Editor’s note:

When studying pharmacology, are you also interested in the intricate mechanism of action of various drugs, various clinical applications, various Headaches from adverse reactions and contraindications? Don’t worry, Xiehe 8 will launch a series of academic notes to review and sort out the pharmacology content with you.

diabetes mellitusis a metabolic disease caused by defects in insulin secretion and/or insulin action caused by genetic and environmental factors. , Abnormal fat and protein metabolism, with hyperglycemia as the main sign. In recent years, with the rapid social transformation, the incidence of diabetes in my country has exploded. Diabetes can cause acute complications such as ketoacidosis, lactic acidosis, hyperosmolar syndrome, and infection, as well as chronic complications such as diabetic nephropathy, diabetic retinopathy, and diabetic neuropathy, as well as hypertension, coronary heart disease, and stroke. and many other major vascular diseases.

The goal of diabetes treatment is to eliminate diabetes symptoms and prevent acute and chronic complications through good glycemic and metabolic control. The treatment of diabetes adopts the principle of comprehensive treatment, and drug treatment, diet treatment, exercise treatment, disease monitoring, education and psychological treatment are indispensable “five carriages”. For patients with type 1 diabetes, due to pancreatic β-cell damage, oral medication is often ineffective, and they need to rely on insulin for life; for patients with type 2 diabetes, oral medication is effective when the condition is not severe.

Diabetes is the result of multiple mechanisms, including decreased β-cell insulin secretion, α-cell increased postprandial glucagon secretion, increased hepatic glucose output, and neurotransmitter function Disorders, decreased skeletal muscle glucose absorption, increased renal glucose reabsorption, increased fat hydrolysis & decreased glucose absorption, decreased incretin function, etc. Aiming at the above mechanisms, diabetes treatment drugs include insulin preparations, as well as 5 types of hypoglycemic drugs: biguanides, insulin secretagogues, insulin sensitizers, α-glucosidase inhibitors, and SGLT2 inhibitors.

How do these hypoglycemic drugs control blood sugar and regulate metabolism? What are the key points in clinical application? Let’s take a look below with me!

I. Insulin preparations