Preparations of hormones in the diet. The biological role of hormones in the greenhouse

PREPARATIONS HORMONIV TA ЇX ANALOGIV. Part 1

Hormones are chemical substances, which are biologically active words, which produce internal secretions with loses, which come into the shelter and work on the organ of tissue-targeting.

The term "hormone" resembles the Greek word "hormao" - porushuvati, zmushuvati, sponukati to activity. In this hour, the structure of more hormones and synthesized ones has been deciphered.

For chemical buda hormonal drugs, such as hormones are classified:

a) hormones of a protein and peptide structure (preparations of hormones of the hypothalamus, hypophysis, parathyroid and pidshlunkovaya zalosis, calcitonin);

b) lost amino acids (iodine derived amino acids - hormone preparations thyroid gland, Mozkovy ball of supra-nirkovy vines);

c) steroid spoluca (preparations of hormones from measles supra-nirkovyi and statovykh zalosis).

In general, the endocrinology of the annual vivic includes more than 100 chemical words synthesized in different organs and systems of organism by special cells.

The development of such types of hormonal pharmacotherapy:

1) replacement therapy (for example, the introduction of insulin for diabet);

2) inhibitory, oppressive therapy with the method of stifling the production of moisture hormones in case of excess (for example, in case of thyrotoxicosis);

3) symptomatic therapy, if the sick person has some hormonal damage in principle, it is not, and hormones and drugs are indicative of those witnesses - in case of severe interruption of rheumatism (like the prototype), it is important fired up eyes, shkiri, allergic illnesses, etc.

REGULATING THE SYNTHESIS OF HORMONES IN THE BODIES

The endocrine system at once from the central nervous system and the immune system regulates the homeostasis of the organism. Vzaєmozv'yazok CNS i sistemi endokrinnoї zdіysnyuєtsya through gіpotalamus, neyrosekretornі klіtini yakogo (reaguyut on atsetilholіn, noradrenalіn, serotonіn, dofamіn) sintezuyut i vidіlyayut rіznі rilіzing-factor I їh іngіbіtori so zvanі lіberіni i statin SSMSC posilyuyut abo blokuyut vivіlnennya vіdpovіdnih gormonіv tropіv from the anterior lobe of the hypophysis (tobto adenohypophysis). In such a rank, the releasing factor of the hypothalamus, infused into adenohypophysis, changes the synthesis and vision of hormones of the rest. In its own heart, the hormones of the anterior lobe of the hypophysis stimulate the synthesis and vision of hormones in the target organs.

In the adenohypophysis (anterior lobe), hormones are synthesized according to the onset of hormones:

Adrenocorticotropic (ACTH);

Growth hormone (STH);

Follicle-stimulating і luteotropic hormone (FSH, LTH);

Thyroid stimulating hormone (TSH).

At the end of the day, the hormones of adenohypophysis of the disease do not just function, but atrophy. Navpaki, with the growth of hormones in the blood, is seen as a seed-target, there is a change in the speed of the synthesis of rilizing - chinniks in the hypothalamus and in the sense of sensitivity to them of hypophysis, On the other hand, with a decrease in the blood plasma of the level of hormones in the target areas, there is a view of the releasing factor, which is related to the tropic hormone. In such a rank, the production of hormones is regulated according to the principle of a vocal link: the less the concentration of hormones in the blood, the more the release of the hormones-regulators of the hypothalamus and the hormones in the anterior lobe of the hypophysis. In addition, it is even more important to remember when carrying out hormonal therapy, as hormonal preparations in the body of a sick person galvanize the synthesis of those hormonal hormones. At the connection with the cym, which signify hormonal preparations, it is necessary to reassess the sick person, to find out the wrong pardons.

MECHANIZM DIV HORMONIV (PREPARATIV)

Hormones, in the form of a chemical budovia, can be infused on the genetic material of the clitinium (on the DNA of the nucleus), or on the specific receptor, rosted on the surface of the clitin, on the ), which leads to the change of the functional stanu klin.

Steroid hormones, having linked to the receptor, migrate into the nucleus, and are linked with specific chromatin dylyans, such a rank, to increase the speed of the synthesis of specific m-RNA into the cytoplasm, to reduce the specificity of the enzyme synthesis.

Catecholamines, polypeptides, bilkovy hormones decrease the activity of adenylate cyclase, increase cAMP instead of cAMP, as a result of which the activity of enzymes decreases, the membrane penetration of clin and in.

Hormone PREPARATIONS

At the bottom of the population, especially in the tail section, there are about 2 million Langerhans' islands, which make up 1% of the mass. Ostrovtsi are stored for alpha-, beta- and delta-clitin, which are capable of producing glucagon, insulin and somatostatin (inducing secretion of hormone growth).

At the end of the lecture, we tell the secret of the beta-clitin of the islands of Langerhans - INSULIN, as in this hour the preparation of insulin with provincial anti-diabetic preparations.

Insulin for the first time of visions in 1921 Rots Banting, Best - for the stench in 1923 Rots rejected the Nobel Prize. Isolation of insulin in crystalline form in 1930 rots (Abel).

In normi insulin is the main regulator of glucose level in the blood. navigate small advices Instead of glucose in the blood, it causes the secretion of insulin and stimulates the synthesis of beta-cells.

Mechanism for insulin dressing with the help of homogenization of tissue with glucose and transmutation into a glycogen. Insulin, which increases the permeability of the membrane cells for glucose and reduces the tissue penetration to it, reducing the penetration of glucose into the cells. In addition to stimulating the transport of glucose into the cell, insulin stimulates the transport of amino acids and calories to the cell.

Clitini is even better for glucose; in them, insulin increases the concentration of glucokinase and glucogen synthetase, which is used to produce glucose up to accumulation and deposition of glucose in the liver of glucogen. For hepatocytes, a depot for glycogen, also cells of transversely dark muscles.

If the insulin is not stable, glucose will not be absorbed by tissues in the hot world, so it will develop hyperglycemia, and if the glucose levels are even higher in the blood (more than 180 mg / l), it will not be glucose (zucor in the section). Zvidsey and the Latin name of the diabetus: "Diabetes mellitus" (diabetics).

Requirement of tissue in glucose value. In a number of tissues - the brain, cells of the healthy food, the seed-producing food - the approval of the energy is given only for the glucose. In the іnshikh fabrics for energizing energy, except glucose, you can eat fatty acids.

In case of a reddish diabetic, the situation is vicious, and in the middle of "prosperity" (hyperglycemia), the clergy will try "hunger".

In the body of a sick person, except in carbohydrate exchange, it is twisted and vid and exchanged. In case of deficiency of insulin, a negative balance of nitrogen is promoted, if amino acids need to be vikorized in gluconeogenesis, whole amino acids are transformed into glucose, when 56 g of glucose is adopted from 100 g of a bottle.

Fat metabolism is also associated with damage, and for all, it is tied to changes in the blood of essential fatty acids (FFA), from which ketones are established (acetoacetic acid). Accumulation of residual disease up to ketoacidosis up to Komi (coma - extreme step impairment of metabolism in case of sugar diabetes). Moreover, in the minds of the brain, the resistance of clitin to insulin is developing.

As a result of the WHO's tribute, in Danish hour the number of sick people per child with diabetes on the planet reached 1 billion Cholovik. For the death of diabetics cardiovascular pathologyі evil new creatures To that end, childhood diabetes is one of the most pressing medical and social problems, as it will require supervised visits for the first time.

According to the current classification of the WHO, the population of ailments for diabetics is divided into two main types:

1. Insular diabetics (formerly called youthful) - ІZSD (SD-I) develop as a result of progressive loss of beta-clitin, and this means interfacing with a lack of insulin secretion. The whole type of debut in up to 30 years and dressings with a multifactorial type of adherence, so as to associate with a number of genes of hystosity of the first and other classes, for example, HLA-DR4 and

HLA-DR3. Individuals with the presence of both antigens -DR4 and

DR3 is sick to the greatest risk of development of insulin-free fallow-red diabetes.

A small part of ailments on the insulin-free fallowing diabet becomes 15-20% of the number.

2. Insulin-independent diabetics - INZSD - (SD-II). Qia form of diabetes is called diabetic grown-up, so as a debut, you will start playing for 40 years.

The development of a type of sugar-coated diabetes is not tied to the head system of gistosumnosti people. In people with a diabetic type in the adolescent zone, it is normal to reduce the number of insulin-producing cells in the Danish hour, so that the ICD grows as a result of the improvement of the resistance to Some of the ailments in the form of diabetes become 80-85%.

The two main types are visible:

3. Sugar diabetes, dressing with lack of food.

4. Secondary, symptomatic diabetes mellitus (endocrine genesis: goiter, acromegaly, sickness of pidshlunkovaya zalozi).

5. Diabetes mellitus.

In Danish hour, a singular methodology was put in place, so that a system of principles and glances at the treatment of ailments to diabetics, the key ones are:

1) compensation for the deficiency insulin;

2) correction of hormonal and metabolic disorders;

3) correction and prevention of early and early development.

According to the remaining principles of treatment, the main methods of therapy for ailments of diabetics are three traditional components:

2) preparations for insulinu for ailments on insulinoplastic diabetics;

3) oral contraceptives for ailments on insulin-dependent diabetes mellitus.

Moreover, we are important є to see the regime and the stages of physical navantages. In the midst of pharmacological problems, how to get sick for the treatment of ailments for diabetics, two main groups of drugs:

I. Preparations insulin.

II. Synthetic oral (tablet) anti-diabetic drugs.

Hormone preparations

At the bottom of the lakes of the people, especially in the tail of the її part, there are about 2 million Langerhans ostrіvtsіv, which becomes 1% of the mass. Ostrіvtsі are stored for a-, b- and l-clitin, which vibrate like glucagon, insulin and somatostatin (inducing secretion of growth hormone).

At the end of the lecture, we have the secret of the b-cells of the islands of Langerhans - INSULIN, as in the given hour of the preparation for insulin with provincial anti-diabetic diseases.

Insulin for the first time of visions in 1921 Rots Banting, Best - for the stench in 1923 Rots rejected the Nobel Prize. Isolation of insulin in crystalline form in 1930 rots (Abel).

In normi insulin is the main regulator of glucose level in the blood. To increase the amount of glucose in the blood instead of glucose for the secretion of insulin and stimulate further synthesis of b-cells.

Mechanism for insulin dressing with the help of homogenization of tissue with glucose and transmutation into a glycogen. Insulin, which increases the permeability of the membrane cells for glucose and reduces the tissue penetration to it, reducing the penetration of glucose into the cells. In addition to stimulating the transport of glucose into the cell, insulin stimulates the transport of amino acids and calories to the cell.

Clitini is even better for glucose; in them, insulin increases the concentration of glucokinase and glucogen synthetase, which is used to produce glucose up to accumulation and deposition of glucose in the liver of glucogen. For hepatocytes, a depot for glycogen, also cells of transversely dark muscles.

If the insulin is not stable, glucose will not be absorbed by tissues in the hot world, so it will develop hyperglycemia, and if the glucose levels are even higher in the blood (more than 180 mg / l), it will not be glucose (zucor in the section). Zvidsey and the Latin name of the diabetus: "Diabetes mellitus" (diabetics).

Requirement of tissue in glucose value. At a number of fabrics

The brain, the healthy food, the seed-producing food - the approval of the energy is given only for the glucose rakhunok. In the іnshikh fabrics for energy production, except glucose, fatty acids can be added.

In case of sugar diabetes (CD), the situation is vicious, in case of average "prosperity" (hyperglycemia), the clergy will taste "hunger".

In the body of a sick person, except in carbohydrate exchange, it is twisted and vid and exchanged. In case of deficiency of insulin, a negative balance of nitrogen is promoted, if amino acids need to be vikorized in gluconeogenesis, whole amino acids are transformed into glucose, when 56 g of glucose is adopted from 100 g of a bottle.

Fat metabolism is also associated with damage, and the first thing for everything, is tied to changes in the blood of essential fatty acids (FFA), from which ketones are established (acetoacetic acid). Accumulation of residual disease up to ketoacidosis up to Komi (coma is the extreme stage of metabolic degradation in diabetes). Moreover, in the minds of the brain, the resistance of clitin to insulin is developing.

As a result of the WHO's tribute, in this hour the number of ailments on the Central House of Nations on the planet reached 1 billion Cholovik. For the death of diabetics, there is a third place for heart-vascular pathology and malignant new diseases, that is, diabetes is one of the most severe medical and social problem, as it will require supervised visits for transmission.

For the current classification of the VOOZ, the population of ailments in the CD is divided into two main types

1. Insular diabetics (formerly called young) - ІZSD (SD-I) develops as a result of progressive b-clitin failure, and this means dressings due to the lack of insulin secretion. The whole type of debut in up to 30 years and dressings with multifactorial type of adherence, so as to associate with a number of genes of hystosity of the first and other classes, for example, HLA-DR3 and HLA-DR3. Individuals with the presence of both antigens -DR4 and -DR3 were strong until the development of the IZSD was the greatest. A part of the ills of the ІZSD becomes 15-20% of the number.

2. Insulin-independent diabetics - INZSD (SD-II). The qia form of diabetics is called diabetic grown-up, so as a debut you will start playing for 40 years.

The development of this type of SD is not tied to the head system of gistosumennosti people. In people with a diabetic type, it is normal to reduce the number of insulin-producing cells in the adolescent zone, but in the Danish hour it is important to develop as a result of the improvement of the resistance to Some of the ailments in the form of diabetes become 80-85%.

The two main types are visible:

3. SD, dressing with lack of food.

4. Secondary, symptomatic diabetes (endocrine genesis: goiter, acromegaly, congestion of pidshlunkovoi zolozi).

5. Diabetes mellitus.

In Danish hour, a singular methodology was put in place, so that a system of principles and glances at the diagnosis of ailments on the Central House, in which key є:

1) compensation for the deficiency insulin;

2) correction of hormonal and metabolic disorders;

3) correction and prevention of early and early development.

According to the remaining principles of treatment, the main methods of therapy for ailments on the CD are overlaid with three traditional components:

2) preparations іnsulіnu for ailments ІZSD;

3) oral contraceptives for the ailments of INZSD.

Moreover, we are important є to see the regime and the stages of physical navantage. Among the pharmacological problems, how to get vicious for the treatment of ailments on the CD, there are two main groups of drugs:

I. Preparations insulin.

II. Synthetic oral (tablet) anti-diabetic drugs.

Pidshlunkova zalosa viroblya a bit of hormones:

glucagon, insulin, somatostatin, gastrin.

Of them insulin it is the most practical value.

insulin gossip v- clitines of the islands of Langerhans.

Clitinus podshlunkovoy zolozi consistently produce a small basal rate of insulinu.

In case of growth on the basis of stimulation (especially glucose), the insulin increases significantly.

Losing the insulin, or the excess factors, which are against their activity,

to develop red diabetes - an important affliction,

yake are characterized by:

high blood glucose (hyperglycemia)

visions from the cross (concentration in the first cross

further reabsorption - glucose)

accumulated products in broken fat exchange - acetone, hydroxybutyric acid -

in the blood with intoxication and development of acidosis (ketoacidosis)

visions from the cross (ketonuria)

progressive measures of capillaries nirok

and cystic membranes of the eyes (retinopathy)

nerve tissue

generalized atherosclerosis

Mechanism for insulinu:

1, bind to the receptor

Membranes have klin for insulin and special receptors,

in conjunction with a hormone in a chain of developing glucose with them.

It is important for fabrics, in those without insulin glucose there is much too little (meat, fat).

To do something about the necessary glucose in the organi, as it is possible to take care of it and without insulin (pechinka, mozok, nirki).

2. Adequacy in the membrane of the glucose transporter

As a result of the linkage of the hormone to the receptor, the enzyme part of the receptor (Tyrosinkinase) is activated.

Tyrosine kinase is included in the process of enzyme exchange of fluvins in cells and the necessary storage from the depot in the membrane of the glucose transporter protein.

3. The insulin-receptor complex enters into the middle of the cell and the active robot of the ribosomes

(Synthesis of a protein) and a genetic apparatus.

4. As a result, anabolic processes and catabolic processes are accepted in the cells.

efekti insulinu

In total nada anabolic and anti-catabolic diet

carbohydrate exchange

To accelerate the transport of glucose through the cytolemma in the cellin

galvanize gluconeogenesis

(Conversion of amino acids into glucose)

Promote the approval of the glycogen

(Activates glucokinase and glycogen synthetase)

galmu glycogenoliz (attracting phosphorylase)

fat metabolism

Driving lipolysis (driving lipase activity)

Zbіlshu synthesis of fatty acids,

I will welcome you

Galmuє transformation of fatty acids and amino acids

in keto acids

bilkovy obmin

Accelerated transport of amino acids into the cell

Diya insulinu:

to the oven

- enhancing the deposition of glucose at viglyadi glycogen for rakhunok

galvanization of glycogenolysis,

ketogenesis,

gluconeogenesis

(Tse chastkovo be provided with a better transport of glucose in the cell and її phosphorylate)

On the skeleton

- activation of the synthesis of the protein vnaslidok

improved transport of amino acids and increased ribosomal activity,

- activation of glycogen synthesis,

stained with robots

(Inspired by glucose transport).

on fat tissue

Increase the deposit of triglycerides

(The most effective form of saving energy in the body)

for the reduction of lipolysis and stimulation of fatty acid metabolism.

symptoms: sprague (polydipsia)

p_advisheniya dіures (polyurіya)

appetite (polyphagia)

weakness

reduction of masi tila

angiopathy

ruinous dawn and in.

Ethiological Classification of Poor Glycemia (WHO, 1999)

The result of storing insulin - a lot of positive changes in the exchange:

Activation of carbohydrate exchange.

Enhanced glucose transport in klitini

Strengthening of vicious glucose in cyclic tricarboxylic acids and supply of glycerophosphate Improving the conversion of glucose into glycogen

galvanizing gluconeogenesis

Reducing the level of zukru in blood - reducing glucosuria.

Transformation of fat metabolism in the bik of lipogenesis.

Activation of the education of triglycerides from virgin fatty acids

as a result, the reliability of glucose and glycerophosphate in adipose tissue

Decrease in the level of essential fatty acids in the blood and

The change in the transformation into ketones in ketones is the result of ketoacidosis.

Change in cholesterol tolerance.

leading to the development of diabetogenic atherosclerosis

As a result, the lipogenesis of the growth of oil is improved.

Bilingual exchange.

Economics of the Amino Acid Fund for the Galvanization of Gluconeogenesis

RNA synthesis activation

Stimulation of synthesis and galvanizing of blood loss.

Diabetes treatment:

For insulin molecule Nobel Prize two were awarded:

In 1923 r - for yogo vidkrittya (Frederic Bunting and John McLeod)

U 1958 r - for the establishment chemistry warehouse(Frederic Senger)

Unsliming flexibility in practice:

From the genial awareness to the conversion to the drug on dogs with a viscous lump has passed for less than 3 months.

After 8 months, the first patient was treated with insulin,

After 2 years, pharmaceutical companies could take care of them for their needs.

hungry dyeta .

Banting and Best.

wordBantingv English it became a housewife 60 years before the opening of the insulin - the boss of William Bunting, a trunar and an uncommon tovstunov.

On St. James's street in London, there are a lot of fun, see and go.

One fine day Banting didn’t go down after the gatherings, so it was roztovstіv.

Todi vin siv for a hungry child.

Svіy dosvіd skudnennya Banting wiklav at the brochure "Sheet about the size, addressing the community". The book was published in 1863 and became a bestseller.

The yogo system has grown so popular that the word "Banting" in the English language has lost the meaning of "hungry for a child."

For the English-language publicity, about the insight into insulin by the name of Banting and Best, a pun was sounded like a pun: Banting and Best - Hungry child and beautiful.

Until the ear of the XX century children with diabetes, weakness, stomachache, persistent spragu, diabetes (up to 20 liters per day), health problems in the smallest wounds and in. can be continued in one empirically known way - starve to death.

With type 2 diabetics, it helped to reach the full amount, with type 1 - a few rocks.

The reason for the development of diabetes began to see the light in 1674 rotsi,

if the London likar Thomas Villis tried to smash the sick for gusto.

Vona appeared with liquorice through those who organizm were-like shlyakhs, having let go of the tsukru.

Linkage to diabetes with impaired functions the middle of the nineteenth century was revealed.

Leonid Vasilovich Sobolov

In 1900-1901 pp having formulated the principle of rejection of insulin.

Rivn tsukru in the blood regulates the hormone of Langerhans ostrovtsy –

having started up in 1916 the English physiologist Sharpy-Schaefer.

Lost smut - vidіliti іnsulіn from pіdshlunkovoї zloz tvarin і zasosuvati yogo for lіkuvannya people.

First, to whom the price is far away, a Canadian licar has appeared Fred Bunting .

Banting tackling the problem of diabetes without the knowledge of robotics and serious scientific training.

Directly from the Batkivskoy farm of wines having joined the University of Toronto.

Then, having served in the army, he was working as a surgeon at the Polish hospital, and he was seriously injured.

Send demobilizatsiya Banting vlashtuvavsya on the landing of the youngest Anatomy and Physiology University of Toronto.

Vin immediately proponed the head of the department to the professor John McLeod take care of the vision of the hormone fodder.

MacLeod, a great Fachivite in the area of ​​diabetics, knew perfectly well how many people in the past ten years unsuccessfully fought over this problem, the proposition that they saw.

Ale through a little bit of misyatsiv Banting proponuvv with an idea, I realized that about 2 years of nights in 1921 r:

ligate the ducts of the pidshlunkovoy zalozi, then trypsin ceases to circulate in them.

The idea turned out to be correct, so that trypsin ceased to break down the protein insulin molecules, and insulin became possible to see.

McLeod went to Scotland and let Bunting go back to his laboratory for 2 months, until he put it on his own. Navigate the video to the student's assistants Charles Best.

Best in vintuozno by starting the concentration of sugar in blood and sech.

Schob dobut koshti Banting has sold his mustache, but he didn’t whistle for the first results.

In 2 months the professor turned around and gave a little sound to Bunting and Best from the laboratory.

Ale, rozibravshis, whom the preachers have risen to reach, secretly connecting the entire department to the robot with them.

Bunting without becoming a patent application.

The retailers have tried out a lot of the preparation on their own - for the succession of todish likars.

The rules are simple, but ailments for diabetics died, so thorough methods of vision and cleansing were carried out in parallel with the clinics.

The stinks riziknuli zrobiti prick lads, who is guilty of dying after a few days.

With a try, it appeared not far away - the unpurified extract of the slurry burrow did not appear

Ale in 3 days 23 June 1922 р When 14-year-old Leonard Thompson sent an uncleanly cleaned insulin, the concentration of zukru in the blood decreased.

Among the first children of Banting, he is a friend, also a car.

Another child, a little girl-child, was brought from the USA to Canada by a mother-likar.

Dіvchintsі Bula zroblena ін'єкція right at the station, there is a Bula in the com.

For that, the yak came to herself, the little girl, got rid of the insulin, lived more than 60 years.

Promisloviy vipusk insulinu pohav lykar, yakogo squad, lykar-endocrinologist, ailing for diabetics, Dane Avgus Krog ( Novo Nordisk- Danish company, yak, until now, one of the most popular virobniks in insulin).

His premiums Banting were poured with Best, and McLeod with Collip (biohimik).

In Canada, Banting became a national hero.

U 1923 r University of Toronto(After 7 years of his completion by Banting) he was awarded the degree of Doctor of Science, having appointed a professor and a new release - especially for the advancement of robotics.

Canadian Parliament I have seen your old school pension.

In 1930 Banting became the director of the scientific to the Institute of Banting and Best, Buv a member Royal Partnership in London by trimming the title of the British official.

With the ear of the 2nd Holy War, win pishov to the front as a volunteer, organizer medical aid.

22 fierce 1941 r Banting zaginuv, lіtak, in any kind of years, having conceived an accident over the snowy wilderness of Newfoundland.

Monuments to Bunting to stand in Canada, in Batkivshchyna and in the middle of the bend.

14 falling leaves - Day of People's Bantinga - the name of the yak day to fight with diabetes .

drugs insulin

Have a short show

Lizpro (Humalog)

An ear of corn in 15 khvili, a triviality of 4 years, to take in front of a horse.

Regular crystalline insulin (Started),

actrapid MK, MP (pig), actrapid H , ilitin P (regular), humulin R

An ear of corn after 30 minutes, triviality 6 years, take 30 minutes before the day.

industrial activity

Semilente MK

An ear of dії in 1 year, triviality 10 years, take a year before іdi.

Strichtsi, strichtsi MK

Ear of corn in 2 years, triviality 24 years, take 2 years before.

Homofan, Protophan H , monotard H , MK

An ear of corn after 45 minutes, triviality 20 years, take 45 minutes before the day.

prolonged release

ultralente MK

Ear of corn in 2 years, triviality 30 years, take 1.5 years before the day.

ultralente Iletin

Ear of corn in 8 years, triviality 25 years, take 2 years before.

Ultrahard H

Humulin U

Ear of corn in 3 years, triviality 25 years, take 3 years before.

Short film preparations:

Introduced inn'єktsіno - pіdshkіrno (with hyperglycemic comі) internally

Incomplete activity - there is a lot of activity at the start of the day (I’m not safe for hypocritical Komi), little triviality of the day.

Medium trivial preparations:

To become stagnant in cases of compensated diabetes mellitus, when taking short-term drugs with sensitivity to insulin.

Preparations for trivial diy:

Introduced only for children.

Adequate preparation of preparations in short and medium trivial events.

MP - monopic: cleansing by the gel filtration method.

MC - monocomponent: purification by molecular sieve and ion exchange chromatography (best quality).

scourge insulin to be derived from human 3 amino acids, great antigenic activity.

pig insulin change from human everything to one amino acid.

human insulin Rejection of the technology of recombinant DNA (helping DNA to another cell and hydrolyzing the directions of proinsulins to the insulin molecule).

Delivery systems to insulin :

infusion systems.

Portable pump.

Implantation autoin'ector

A titanium reservoir is implanted with a supply of insulin for 21 days.

I will drain the reservoir, filled with gas-like phosphate.

A catheter from a titanium reservoir for a blood vessel.

When the heat is generated, the gas expands and ensures uninterrupted supply of insulin to the roof.

nasal spray

In 2005, the United States Food and Drug Administration grabbed the first drug insulin from a nasal spray.

Regular іn'єktsії insulinu

adding to the insulin : Strictly individual.

The optimal dose is responsible for reducing the level of glucose in the blood to normal levels, increasing glucosuria and the symptoms of diabetes.

Areas of children’s schools (Rizna shvidkist vmoktuvannya): the anterior surface of the cranial wall, the outer surface of the shoulders, the front surface of the stegon, s_dnits_.

Short film preparations- in the abdominal area (large shvidke vmoktuvannya),

Advanced drugs- in stegna abo s_dnitsі.

Shoulders are not handy for independent ones.

The effectiveness of therapy is monitored by way

Systematic identification of the "hungry" rіvnya tsukru in blood and

Seeing yogo with a cross for doba

The most rational option for the treatment of diabetes type 1 diabetes -

The mode of bagatorazovyh insulinu, sho іmіtu physiological secretion insulinu.

Physiological minds

the basal (background) secretion of the insulin is displayed without interruption and becomes 1 OD insulin per year.

With physical assignment Insulin secretion in the norm is changing.

Pid hour їzhі

It is necessary to add (stimulated) secretion to insulin (1-2 OD per 10 g of breeders).

Qiu folding secretary insulin can be taken by the next rank:

Before dermal reception, short-dose preparations are injected.

Basal secretion is susceptible to prolonged drug use.

Folding insulin therapy:

hypoglycemia

As a result

Unfortunate welcome to the house,

unpretentious physical navantazhennya,

Introduced unprimed with a high dose of insulin.

appear

zamorochennyam,

tremor,

weak

hypoglikemichna coma

Mossy development of insulin shock, loss of evidence, lethal result.

buy taking glucose.

Deposition of diabetics

diabetic coma

vnaslidok

Stagnation of insufficient doses of insulin,

Destruction of children,

stressful situations.

Diabetic coma without a secret intensive therapy

wait for the lethal result.

As a result

Increased CNS toxicity with ketone bodies,

amiakom,

acidotic zsuvu

ekstrena therapy be carried out internal introduced by insulin.

Before pouring a great dose of insulin into the cell with glucose enter kaliy

(Pechinka, skeletal m'yazi),

Concentration of calories in blood razko falls. As a result, there is a lot of heart activity.

Immunity damage.

Insulin allergy, immune resistance to insulin.

Lipodystrophy in the center

Paratyroidin- a drug for the parathyroid hormone parathyroidism (parathyroid hormone), the rest of the hour stagnates even more rarely, so yak є more efficiently... The regulation of hormone production is in the form of Ca 2+ in the blood. Hypophyse is not infused into the synthesis of parathyrin.

Pharmacological polygens in the regulation of calcium and phosphorus metabolism. Organs-targets of the yogo-cystka and nirka, in which-specific membrane receptor for parathyrin. In the intestine, parathyrin activates the absorption of calcium and inorganic phosphate. Vvazayut, scho stimulating infusion on soaking calcium into the intestines of dressings not with a direct infusion of parathyrin, but with an increase in coverage calcitriol (Active form calciferol in nirkah). V nirkovy tubules parathyrin increased calcium reabsorption and decreased phosphate reabsorption. With a large amount of phosphorus in the blood, it changes, and the calcium grows overnight.

The normal level of parathyrin has little anabolic (osteoplastic) effect due to increased growth and minimalization of cysts. In case of hyperfunction of parathyroid vases, osteoporosis, hyperplasia of fibrous tissue, can be caused to deformity of cysts, fractures. In the case of hyperproducts, parathyrin should be administered calcitonin, Yakiy zapobigє vimivannya kaltsіyu s kіstkovoї fabrics.

show: hypoparathyroidism, for the prevention of tetany in conjunction with hypocalcemia (in the state of the art, intravenously injecting calcium preparations or a combination of hormone preparations in parathyroid valleys).

Prototype indications: allegations of calcium in the blood, with heart disease, nirok, allergic development.

digidrotachistol (takhistin) - for chemical budova close to ergocalciferol (vitamin D2). Zbіlshu absorption of calcium in the intestine, one hour - seeing phosphorus from the cross section. On the basis of ergocalciferol D-vitamin activity is mute.

show: destruction of phosphorus-calcium metabolism, including hypocalcemia, spasmophilia, allergic reactions, hypoparatiroidism.

Prototype indications: Allowances instead of calcium in the blood.

Pobichna diya: Nudota.

hormonal drugs pidshlunkovoy zalozi.

drugs insulin

The regulation of the processes of exchange in the body has a great significance for the hormones of the fodder. V β-cells pancreatic islands are synthesized insulin, yaky maє virazhenu hіpoglіkemіchnu dіu, in a-cells circulate counterinsular hormone glucagon, Yakiy maє gіperglіkemіchnu dіu. Besides, δ-Cletia swallow somatostatin .

With a lack of insulin secretion, diabetic diabetes (CD) develops - diabetes mellitus - zhvoryuvannya, yake borrowed one of the dramatic sides of light medicine. According to the VOOZ estimate, the number of ailments in the Central House of Commons in the United States in 2000 brought 151 million people until 2010, the growth of up to 221 million people will be determined, and by 2025 - 330 million people, so let’s talk about this global epidemic. SD wiklikak most early on from the worsening incapacitation, high mortality, frequent sleepiness, nirkova lack, And also є factor riziku heart-and-heart disease... SD will sit pershe mіsce middle endocrine disease... The organization of the United Nations public voiced the SD to the pandemic of the XXI century.

For the classification of the VOOZ (1999) Two main types of diseases are developed - diabetes type 1 and type 2(Apparently, insulin-independent and insulin-independent CD). Moreover, an increase in the number of ailments is predicted in the main for ailments on a type 2 CD, which in this hour will store 85-90% of the total number of ailments for diabetes. The whole type of SD is diagnosed 10 times more often than the SD type 1.

For the treatment of CD, the drug should be consumed, insulin preparations and oral anti-abetic preparations. ineffectively lіkuvannya ailing C D is guilty of preserving approximately the same basal rhyvnu insulin by holding out and preventing hyperglycemia, so that it is possible to take the disease (post-prandial glycemia).

The main і і HbA1C or A1C. НbА1с or А1С - hemoglobin, which is covalently bound with glucose and is an indicator of the level of glucose for 2-3 months in advance. Yoho rivn is good because of the significant indicators of glucose in the blood and the speed of sugar diabetes. A decrease in the level of glucose hemoglobin by 1% will lead to a decrease in the risk of developing diabetes by 35% (directly from the type of hemoglobin level HbA1c).

The basis for the treatment of C D є is the correct selection of sucrose-nodular therapy.

Historical add-on. Principles of rejection of insulin buli rozrobleni L.V. Sobolivim (born in 1901), Yakiy in experiments on young calves' young calves (they have no more trypsin, put insulin) showing that they are a substrate for internal cells At 1921 r .. Canada's Vcheni FG Banting and Ch. X. Best saw a pure insulin and broke the method of industrial rejection. Thirty-three years later, Senjer and his fellow students deciphered the primary structure of the insulin of the great horny thinness, for which they rejected the Nobel Prize.

The preparation of drugs in insulin was added to the list of stages:

Insulin of the first generation - pig and cow's (scourge) insulin;

Insulars of another generation - monopic and mono-component insulin (50s of the XX century)

Insulin of the third generation - napivsynthetic and genetic engineering insulin (80s of the XX century)

Otrivialization of insulin analogs and ingalatizing insulinu (end XX - ear of XXI century).

The insulin creatures were produced from the insulin people behind the amino acid warehouse: scourge insulin - in three positions for amino acids, pigs - in one position (30 in the lancet U). With the treatment of pestilent insulin, there is a small minority of vicious immunological reactions, but not with the therapy with swine or human insulin. These reactions turned into the development of immunological resistance and allergy to insulin.

For the reduction of immunological authorities, preparations in the insulin of disintegration of special methods of purification, which made it possible to eliminate other generation. A collection of boules monopic insulin, recognized by gel chromatography. As soon as the bulo is established, the stench can be found in a small number of houses of insulin-like peptides. At the next stage, the stem of the monocomponent insulin (MK-insulin), which was trimmed with additional purification using ion exchange chromatography, was removed. With the stagnation of monocomponent pig insulin production of antibodies and development of muscle reactions, the ailments develop very rarely (the infection of pigs and monopoly pig insulin in Ukraine is not stagnant).

The preparations for human insulin should be distilled by a synthetic method, with an additional enzyme-chemical substitution in the position of B30 in porcine insulin amino acid alanine for threonine, or by a biosynthetic method using genetic engineering. Practice has shown that there is a lot of clinical development between human insulin and high-quality monocomponent pig insulin mute.

The infection of the trivial robot over the thoroughly and thoroughly shook of new forms of insulinu.

For a chemistry budovy insulin є bіlkom, a molecule of which is stored in 51 amino acids, but two polypeptide lantsyuga are set up, which are divided into two sulphide mixtures. V physiological regulation the synthesis of insulin dominates the role of the increase in concentration glucose at the blood. Penetrating into β-cells, glucose metabolism is based on the growth of intracellular ATP change. Remaining, blocking ATP-depleted calyevi channels, wickling depolarization of the cell membrane. The process of penetration into β-cells of ionic calcium (through potential deposits of calcium channels, as they become crystallized) and the development of insulin by way of exocytosis. In addition, amino acids, fatty acids, glucagon, secretin, electrolytes (especially Ca 2+) are injected into the insulin secretion, autonomous nervous system(The nervous system of the galvanic is sympathetic, and the stimulating infusion is parasympathetic).

Pharmacodynamics. Diya insulinu is focused on the exchange of carbohydrates, bile, fat, minerals. The head in insulinu is a regulating inflow for the exchange of carbohydrates, a decrease in the amount of glucose in the blood. It is not possible to reach those who are insulin in the active transport of glucose and other hexoses, as well as pentoses through the cell membranes and utilization of liver, meat and fatty tissues. Insulin stimulates glycolysis, induces synthesis of glucokinase enzymes, phosphofructokinase and pyruvate kinase, stimulates the pentose phosphate cycle, activates glucose-6-phosphate dehydrogenase, activates the synthesis of glucogenase, activates the synthesis of glucogenesis On the other side, the hormone drives glucogenolysis (distribution to glucogen) and gluconeogenesis.

It is important for the insulin to have a role in stimulating the biosynthesis of nucleotides, stimulating 3.5 nucleotases, nucleoside triphosphatase, including in the nuclear envelope, and regulating the transport of mRNA from the nucleus to the cytoplasm. Insulin stimulates the biosynthesis of nucleic acids, bilkiv. At the same time, until the anabolic processes become stronger, they insulin galvanic catabolic reactions to the fall of the protein molecules. It also stimulates the processes of lipogenesis, the introduction of glucerin into lipids. Of order of synthesis trіglі- tserіdіv іnsulіn aktivuє synthesis in adipose klіtinah fosfolіpіdіv (fosfatіdіlholі- well, fosfatidiletanolamіn, fosfatіdіlіnozіt kardіolіpіnu i) stimulyuє takozh bіosintez cholesterol, neobhіdnogo, podіbno fosfolіpіdіv i deyakih glіkoproteі- Novii for pobudovi klіtinnih membranes.

If there is a lack of insulin, lipogenesis is induced, chi-polis increases, peroxidation of lipids in the blood and in the blood grows in the amount of ketone bodies. In addition to the decreased activity of lipoproteinlipase in the blood of growth, the concentration of β-lipoprotein, which may be more significant in the development of atherosclerosis. Insulin zapobіgє vratі organism of birth and K + with a cross.

The essence of the molecular mechanism of insulin on the internal processes is not rosary. However, the first lanka dії insulinu linking with specific receptors of the plasma membrane of clitin-targets, in front of the liver, adipose tissue and myases.

Insulin z'unitsya at the α-subunit of the receptor (to replace the main insulin-ligation domain). When the kinase activity of the β-subunit of the receptor (Tyrosinkinase) is stimulated, it is autophosphorized. A complex "insulin + receptor" is formed, which penetrates endocytosis through the middle of the cell, deinsulin is triggered and triggered by cell mechanisms of the hormone.

In the clinical mechanisms of insulin, it is not only the secondary intermediaries that take part in the process: cAMP, Ca 2+, the complex "calcium - calmodulin" fructose-2,6-diphosphate, which is called the third mediator of insulin in its inflow to internal biochemical processes. The growth itself is increased with the insulin level of fructose-2,6-diphosphate for the utilization of glucose from the blood, approved from its fat.

There are a number of factors on the number of receptors and on the health of them before they are connected. Zokrema, the number of receptors is reduced in obesity, non-insulin dependent diabetes mellitus type 2, peripheral hyperinsulism.

The insulin receptor is not only visible on the plasma membrane, but in the membrane components of such internal organelles, such as the nucleus, endoplasmic fissure, Golgi complex. Introducing insulin intolerance to diabetes mellitus with a decrease in the level of glucose in the blood and accumulated glycogen in tissues, a decrease in glucosuria and related polyuria, polydipsia.

As a result of normalization of protein metabolism, the concentration in the section of nitrogen spolu changes, and as a result of the normalization of fat metabolism from the blood and section of ketones, acetone, acetoacetic acid and hydroxy oil. Lean on lean and znika overwhelmed by hunger ( bulimia ). The growth of the detoxification function of the liver, the increase in the definition of the organisms and infections.

Classification. modern drugsіnsulіnu develops among themselves shvidkistyu і trivial action. You can distribute on the steps of a group:

1. Preparations insulin for a short period, for simple insulin ( Aktrapid MK , humulin The lowering of glucose level in the blood of a child's blood supply should be repaired after 15-30 minutes, the maximum effect will last after 1.5-3 years, continue until 6-8 hours.

Historical advances in pre-existing molecular structure, biological activity political powers led to the modification of the formulas of the human insulin and to the distribution of analogs to the insulin short action.

The first analogue is lizproinsulin (humalog) Identical to the human insulin, behind the vignette of the position of the lizin and proline in the positions 28 and 29 B-lantsyug. Such a change did not interfere with the activity of A-lancyug, it altered the processes of self-associa tion of molecules insulinu and prevented accelerated absorption from the pedagogical depot. Pislya in ін'єкції ін'єкції the ear in 5-15 minutes, reaching the peak in 30-90 minutes, the triviality of the day is 3-4 years.

Another analogue is aspart (Trade name - novo-rapid) Modifications by way of replacing one amino acid in position B-28 (proline) for aspartic acid, changing the manifestation of self-aggregation of a clitin of insulin molecules in dimmer and hexamer, and accelerating its moisture.

The third analogue is glyulyzin(Trade name epidra) Practically analogous to endogenous human insulin and biosynthetic human insulin with singular structural changes in formulas. So, in the B3-positioned asparagine is substituted for lysine, and lysine in the position B29 is substituted for glutamic acid. Stimulating peripheral vikorystannya glucose skeletal meat adipose tissue, which induces gluconeogenesis in the liver, glucose (epidra) increases the glucose control;

2. Preparations іnsulіnu trivaloi dії:

2.1. average triviality (The ear of a child's education is introduced in 1.5-2 years, the triviality is 8-12 years). These preparations are called insulin-semilente. Prior to the whole group, insulate the neutral Protamina Hagedorn: B-insulin, Monodar B, Farmasulin HNP... Oskilki in HNP-insulin included insulin and protamine in children, isophanies, sportsmen, which are also called isofanovins;

2.2. trivaloi diy (ultralente) h by the cob in 6-8 years, triviality in 20-30 years. We provide insulin preparations here, so that they can take Zn2 + in their warehouse: suspension-insulin-ultralente, Farmasulin HL... The drugs are trivial to inject only pediatric or internally.

3. combined preparations, Also place in your warehouse standard sums of drugs of 1 group with NPH-insulin in small spiws of 1 and 2 groups: 30/70, 20 / 80,10 / 90, etc. - Monodar Do ZO, Farmasulin 30/70 t. Deyaki preparations are dispensed in special syringe-tubes.

To achieve maximum control of glucose in patients with ailments, such a mode of insulin therapy is required, which will increase the physiological profile of insulin with a stretch of dob. Insulin trivalo dії may cause their inadequacy, in the wake of the appearance of a peak effect in 5-7 years after the introduction of the drug, to develop hypotension, especially at night. Some shortcomings have led to the development of analogs of insulin with pharmacokinetic authorities of effective basic insulin therapy.

One of these drugs in the formations of the company Aventis is insulin glargin (Lantus), Yakiy come out of the human three with amino acid surpluses. Glargin-in Sulin is a stable insulin structure, increased in growth at pH 4.0. The drug is not discernible in pediatric tissue, yaka has a pH of 7.4, but it must be produced until micropreparations are established in the bloodstream. Supplement with low zinc concentration (30 μg / ml). When you get wet, glargine-insulin will not ruin the drink and will prevent the practically basal concentration of insulin by pulling it out.

The marketing of new promising drugs in insulin is being carried out - ingalyatsiyyniy insulin (stemming insulin-nutritional sum for ingaling) oral insulin (spray for emptying the company); bukalny іnsulіn (at the viglyadі there is a drop for mouth emptying).

The new method of insulinotherapy is the introduction of insulin after an additional insulin pump, without a greater physiological method of introducing the drug, the visibility of the insulin depot in the nursery.

The activity of the drug in insulin is determined by the method of biological standardization and rotates in OD. 1 OD based on activity 0.04082 mg of crystalline insulin. The dose of insulin for a skin ailment is taken individually in the minds of the stationary with continuous monitoring of the level of НbА1с in the blood and instead of the sugar in the blood and in response to the drug. When rozrakhunka dobovoy dozi insulinu slіd vrahovuvati, scho 1 OD insulinu spriyє will take 4-5 g of zukru, which can be seen from the cut. The ailing one should be transferred to a child with a small amount of easily consumed carbohydrates.

It is easy to introduce insulin 30-45 min before the day. Insecurity of the average triviality of the day is stagnant, as a rule, two (for one year before the day and about 18.00 before the evening). Preparations of trivial diy should be administered at the same time with simple insulin vrants.

There are two main options for insulin therapy: traditional and intensive.

traditional insulinotherapy- the price of the standard sums for a short day insulin and NPH-insulin 2/3 dose before the snack, 1/3 - before the evening. However, with this type of therapy there is little hyperinsulinemia, which is 5-6-fold when it reaches a stretch, and a powerful development of hypooglycemia, a high frequency of accelerated CD.

Intensive (basic-bolus) insulin therapy- the price of a week for the end of the day (for the end of the basal level of the hormone) and additional introduction before the day With a whole type of therapy, the patient himself takes a dose of insulin on the basis of an increase in blood glucose for an additional glucometer.

show: Insulinotherapy is absolutely indicated for patients with type 1 diabetes. physical activity and oral anti-diabetic drugs do not give rise to the necessary effect. Simple insulin stagnation with diabetic Komi, as well as with diabetics of any type, as well as with accelerated disease: ketoacidosis, associated with infections, gangrene, with ailments, heart surgery, stoves during the operational period; for polіpshennya kharchuvannya ailments, hanging out with a trivial ailment; in the warehouses of the polarizing madness in case of heart trouble.

Prototype indications: ailment with hypoglycemia, hepatitis, liver cirrhosis, pancreatitis, glomerulonephritis, nirkovokam'yana ailment, Virazkov's ailment shlunk і twelve-fingered intestine, decompensated heart defects; for drugs in trivalo diy - coma, Infectious diseases, in period surgical treatment ailing at the central house.

Pobichna diya ailment in іn'ktsіy, miscellaneous ignition reactions (іnfіltrati), allergic reactions, determination of resistance to the drug, development of lypodystrophy.

In case of overdosed insulin, you can win hypoglycemia. Symptoms of hypoglycemia: unconsciousness, weakness, cold pit, tremulous symptoms. Quite a decrease in blood supply to the destruction of the functions of the brain, the development of the Komi, by the court and to bring death. Hvori SD for the loss of hypooglycemia guilty of a mother with her own little shmatochkiv tsukru. If the symptoms of hypoglycemia are not known, it is necessary to inject 20-40 ml of a 40% glucose range internally, and 0.5 ml of 0.1% adrenaline range can be administered intravenously. In the case of significant hypoglycemia, in cases of increased medications in insulin, in sick people, it is more important to be more important, not in hypoglicemia, viciklikan preparations and insulin in a short period. The evidence in some of the drugs of the trivial type of protein to protamine will explain the unrepentant indications of allergic reactions. However, the іn'єktsії drugsіv insulinu trivaloіy dії less pain, which is tied to a higher pH of these drugs.

Book: Lecture notes Pharmacology

10.4. Preparations of hormones in pidshlunkovoy zalozi, preparations of insulin.

The regulation of the processes of exchange in the body has a great significance for the hormones of the fodder. According to the cells of pancreatic acute cells, insulin is synthesized, which is a high hypoglycemic effect, in a-cells the counterinsular hormone glucagon is produced, which is a low hyperglycemic activity. In addition, L-cellini underwhelmed by somatostatin.

Principles of rejection of insulin is broken by L.V. Sobol'vim (1901), which in experiments on the young calves (they still have no trypsin, the storage of insulin), showing that the substrate of the inner chamber is In 1921, the Canadian celebrations of FG Banting and Ch. X. Best saw a pure insulin and broke the method of this industrial rejection. Through 33 rocks, Senger, with fellow athletes, deciphered the primary structure of the insulin of great horny thinness, for which he received the Nobel Prize.

yak lykarskiy zasib zastosovat іnsulіn from pіdshlunkovo ​​ї zloz zabіynoi thinness. Close for a chemistry budova to insulinu people є a preparation for slurrying pigs (form only one amino acid). An hour will stop the drugs for the insulin of people, as well as the significant successes in the field of biotechnological synthesis of insulin for people for additional genetic engineering. The great advances in molecular biology, molecular genetics and endocrinology, some homologous human insulin, on the mind of a heterologous creature, not a negative immune response.

For chemistry budovy insulin - a chain of blocks, a molecule of which is stored in 51 amino acids, which is made up of two polypeptide lancers, and two disulfide mists. In the physiological regulation of the synthesis of insulin, the dominant role is the development of glucose concentration in the blood. Penetrating into P-celline, glucose is metabolized and transformed into an intracellular change in ATP. Remaining, blocking ATP-depleted calyevi channels, wickling depolarization of the cell membrane. The process of penetration into the R-cells of ionic calcium (through the potential of the calcium channels, as they become crystallized) and the development of insulin by way of exocytosis. In addition, aminic acids, fatty acids, glucogen, I secretin, electrolytes (especially C2 +), the autonomic nervous system (sympathetic and parasympathetic) are injected into the insulin secretion.

Pharmacodynamics. Diya insulinu is aimed at the exchange of carbohydrates, bile, І fats, minerals. The most important thing in insulin is the regulating inflow of carbohydrate metabolism, reduction of glucose in the blood, and at the same time it is possible to reach the active transport of glucose and other hexoses through the membrane of pentoses fabrics. Insulin stimulates glycolysis, induces synthesis of enzymes and glucokinase, phosphofructoinase and pyruvate kinase, stimulates pentose phosphate cycle I, activates glucose phosphate dehydrogenase, activates glycogenase synthesis On the other side, the hormone induces glycogenolysis (distribution to glycogen) and glyconeogenesis.

It is important for insulin to have a role in stimulating the biosynthesis of nucleotides, promoted in the place of 3,5-nucleotases, nucleoside triphosphatase, including in the nuclear envelope, and, in the first place, by regulating the transport of m-RNA from the nucleus and II. Insulin stimuli biocin - I thesis of nucleic acids, bilkiv. Parallel to the activation of anabolic processes and insulin galvanic catabolic reactions to the fall of protein molecules. It also stimulates the processes of lipogenesis, the education of glucerin and the introduction of it before lipogenesis. Assignment І with the synthesis of triglycerides, insulin activates in the fatty membranes, the synthesis of phospholipids (phosphatidylcholine, phosphatidylethanolamine, phosphatidylinose and cardiolipin needlessly), also stimulates the synthesis of phospholipids,

Due to the lack of insulin, lipogenesis is caused, lipolysis, peroxidation of lipids, in the blood and in the blood grows a number of ketone bodies. In addition to a decrease in the activity of lipoprotein in the blood of growth, the concentration of P-lipoprotein, which may be more significant in the development of atherosclerosis. Insulin zapobіgє vratі organism of birth and K + with a cross.

The essence of the molecular mechanism of insulin on the internal processes of openness is not found. The first lanka for insulin is the connection with specific receptors of the plasma membrane of clitin-targets, in front of the liver, adipose tissue and myases.

Insulin is removed from the wasp-subunit of the receptor (to remove the main insulin receptor "ulcerative domain). At the same time, the kinase activity of the P-subunit of the receptor (tyrosinkinase) is stimulated. Insulation is triggered and triggered by clinical mechanisms of the hormone.

In klіtinnih mehanіzmah dії іnsulіnu take fate not tіlki vtorinnі poseredniki: cAMP, Ca2 +, complex kaltsіy-kalmodulіn, іnozіttrіfosfat, dіatsіlglіtserol, ale i fruktpozo-2,6-diphosphate, yaky nazivayut tretіm poserednikom іnsulіnu in Yogo vplivі on vnutrіshnoklіtinnі bіohіmіchnі Process. The growth itself is increased with the insulin level of fructose-2,6-diphosphate for the utilization of glucose from the blood, approved from its fat.

There are a number of factors on the number of receptors and the number of receptors before the release of a number of factors;

The insulin receptor is not only visible on the plasma membrane, but in the membrane components of such internal organelles, such as the nucleus, endoplasmic fissure, Golgi complex.

Introducing insulin into a diabetic patient with a decrease in the level of glucose in the blood and accumulated glycogen in tissues, a decrease in glucose and associated polyuria, polydipsis.

As a result of normalization of the metabolic exchange, the concentration in the section of nitrogen spoluch changes, and as a result of the normalization of fat metabolism in the blood and in the section there is an increase in ketone thyl - acetone, acid and acetoacetic acid. To lean towards the thinness and znika overwhelmingly feeling hunger (bulimia). The growth of the detoxification function of the liver, the increase in the definition of the organisms and infections.

Classification. Various insulin preparations are developed between fast and trivial activities. It can be divided into the following groups:

1. Preparations for short-term insulin, for simple insulin (mono-insulin MK ak-trap, humulin, homorap and in.) A decrease in glucose level in the blood of a given introduction should be repaired in 15-30 days, it will take a maximum of 15-30 days diya trivaє up to 6-8 hours

2. Preparations for insulin advanced diy:

a) middle triviality (ear in 1.5-2 years, triviality 8-12 years) - suspension-insulin-semilenthe, B-insulin;

b) trivial diy (ear in 6 - 8 years., triviality 20-30 years.) - suspension-insulin-ultralente. Preparations of the advanced type should be administered in a pediatric or internal manner.

3. Combined preparations to be placed in your warehouse of Insulin 1-2-ї groups, for example

Scarb 25% simple insulin and 75% insulin ultralente.

Deyak_ preparations are vypuskayut in syringe tubes.

The insulin preparations are dosed in units of diy (OD). The dose of insulin for a skin ailment is taken individually in the minds of the hospital attendant for continuous monitoring of the level of glucose in the blood and for the prescribed drug (1 OD hormone for 4-5 g of glucose, which can be seen using the same method; The ailing one should be transferred to a child with a small amount of easily consumed carbohydrates.

Falsely dzherela rejected the development of insulin, visions of pigs (C), great horned thinness (G), human (H - hominis), as well as syntheses using genetic engineering methods.

Behind the step of cleansing the insulin of food-grade walking, there are mono-components (MP, foreign - MP) and mono-components (MK, foreign - MS).

Shown. Insulinotherapy is absolutely indicated for people with insulinoplasty diabetics. If the disease is normalized, physical activity and oral anti-diabetic drugs will not fail to produce the desired effect. Insulin stasis when diabetic Komi, And also we are sick for diabetics, of any type, when we are ill with superfluous diseases (ketoacidosis, infection, gangrene, etc.); for short absorption of glucose in case of heart disease, liver disease, surgical operations, in the period of operation (5th OD); for polіpshennya kharchuvannya ailments, hanging out with a trivial ailment; Ridko for shock therapy - in psychiatric practice in case of various forms of schizophrenia; in the warehouses of polarizing sums in case of ailments of the heart.

Prototype indications: sickness with hypoglycemia, hepatitis, cirrhosis of the liver, pancreatitis, glomerulonephritis, nirkovo-kam'yan ailment, creeping ailment of the slunk and two-fingered intestines, decompensated heart defects; for preparations of advanced children - comatose, infectious diseases, in the period of surgical treatment of illnesses for diabetics.

A side effect: the ailment of the reaction, miscellaneous ignition reactions (infiltration), allergic reactions.

In case of an overdose of insulin, hypoglycemia may be diagnosed. Symptoms of hypoglycemia: unconsciousness, weakness, cold pit, tremulous symptoms. Significant lowering of glucose in the blood will lead to the deterioration of the functions of the brain, the development of the Komi, by the court and to bring death. Ailment for a child's diabetic for the loss of hypoglycemia guilty to a mother when she has her own little shmatochki. As soon as the symptoms of hypoglycemia are accepted, it is necessary to introduce 20-40 ml of 40% glucose dose internally, 0.5 ml of 0.1% adrenaline dose is needed. In the case of significant hypoglycemia, in cases of increased medications in insulin, the disease is more important from the beginning, not in hypooglycemia, viclikan preparations, in the insulin of a short period. I will explain to the protamina some of the symptoms of allergic reactions in some of the preparations of the advanced stage. However, the іn'єktsії preparations іv insulinu prodzhennogo іії sore, which is tied to a higher pH of these drugs.