Biguanide

(Redirected from Biguanides)
Jump to navigation Jump to search

WikiDoc Resources for Biguanide

Articles

Most recent articles on Biguanide

Most cited articles on Biguanide

Review articles on Biguanide

Articles on Biguanide in N Eng J Med, Lancet, BMJ

Media

Powerpoint slides on Biguanide

Images of Biguanide

Photos of Biguanide

Podcasts & MP3s on Biguanide

Videos on Biguanide

Evidence Based Medicine

Cochrane Collaboration on Biguanide

Bandolier on Biguanide

TRIP on Biguanide

Clinical Trials

Ongoing Trials on Biguanide at Clinical Trials.gov

Trial results on Biguanide

Clinical Trials on Biguanide at Google

Guidelines / Policies / Govt

US National Guidelines Clearinghouse on Biguanide

NICE Guidance on Biguanide

NHS PRODIGY Guidance

FDA on Biguanide

CDC on Biguanide

Books

Books on Biguanide

News

Biguanide in the news

Be alerted to news on Biguanide

News trends on Biguanide

Commentary

Blogs on Biguanide

Definitions

Definitions of Biguanide

Patient Resources / Community

Patient resources on Biguanide

Discussion groups on Biguanide

Patient Handouts on Biguanide

Directions to Hospitals Treating Biguanide

Risk calculators and risk factors for Biguanide

Healthcare Provider Resources

Symptoms of Biguanide

Causes & Risk Factors for Biguanide

Diagnostic studies for Biguanide

Treatment of Biguanide

Continuing Medical Education (CME)

CME Programs on Biguanide

International

Biguanide en Espanol

Biguanide en Francais

Business

Biguanide in the Marketplace

Patents on Biguanide

Experimental / Informatics

List of terms related to Biguanide


Metformin
Error creating thumbnail: File missing
Buformin. Note extra butane at bottom right.
Error creating thumbnail: File missing
Phenformin. Note extra phenyl at left.

Biguanides (ATC A10 BA) form a class of oral antihyperglycemic drugs used for diabetes mellitus or prediabetes treatment.

Examples

Examples of biguanides:

Proguanil is a biguanide used not for diabetes, but rather as an antimalarial drug.

History

Galega officinalis was used for diabetes treatment in traditional medicine for centuries. In the 1920s, guanidine compounds were discovered in Galega extracts. Animal studies showed that these compunds lowered blood glucose levels. Some less toxic derivatives, synthalin A and synthalin B, were used for diabetes treatment, but after the discovery of insulin they were forgotten for the next several decades. Biguanides were reintroduced into Type 2 diabetes treatment in the late 1950s. Initially phenformin was widely used, but its potential for sometimes fatal lactic acidosis resulted in its withdrawal from pharmacotherapy in most pharmacopeias (in the U.S. in 1977). Metformin has a much better safety profile, and it is the principal biguanide drug used in pharmacotherapy worldwide.

Pharmacotherapy

Biguanides do not affect the output of insulin, unlike other hypoglycemic agents such as sulfonylureas and meglitinides. Therefore, they are not only effective in Type 2 diabetics, but they can also be effective in Type 1 patients in concert with insulin therapy.

Mode of action

The exact mode of action of biguanides is not fully elucidated. However, in hyperinsulinemia, biguanides can lower fasting levels of insulin in plasma. Their therapeutic uses derive from their tendency to reduce gluconeogenesis in the liver, and as a result, reduces the level of glucose in the blood. Biguanides also tend to make the cells of the body more willing to absorb glucose already present in the blood stream, and there again reducing the level of glucose in the plasma.

Side effects and toxicity

The most common side effect is diarrhea and dyspepsia, occurring in up to 30% of patients. The most important and serious side effect is lactic acidosis. Phenformin and buformin are more prone to cause acidosis than metformin therefore they have been practically replaced by it. However, when metformin is combined with other drugs (combination therapy), hypoglycemia and other side effects are possible.

Template:Oral hypoglycemics Template:Antimalarials


Template:WikiDoc Sources