Biguanide

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Biguanide
Skeletal formula of biguanide
Ball and stick model of biguanide
Identifiers
CAS number 56-03-1 YesY
PubChem 5939
ChemSpider 5726 YesY
EC number 200-251-8
KEGG C07672 YesY
ChEBI CHEBI:3095 YesY
Beilstein Reference 507183
Gmelin Reference 240093
Jmol-3D images Image 1
Image 2
Properties
Molecular formula C2H7N5
Molar mass 101.11 g mol−1
Except where noted otherwise, data are given for materials in their standard state (at 25 °C (77 °F), 100 kPa)
 YesY (verify) (what is: YesY/N?)
Infobox references

Biguanide is the organic compound with the formula HN(C(NH)NH2)2. It is a colourless solid that dissolves in water to give highly basic solution. These solutions slowly hydrolyse to ammonia and urea.[1]

Biguanidine drugs[edit]

Biguanidine also refers to a class of drugs based upon the biguanidine molecule.[2] Biguanides can function as oral antihyperglycemic drugs used for diabetes mellitus or prediabetes treatment. They are also used as antimalarial drugs.The disinfectant polyaminopropyl biguanide (PAPB) features biguanide functional groups.

Examples of biguanides:

History[edit]

Galega officinalis (French lilac) 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 compounds 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.

Mechanistic aspects[edit]

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

The mechanism of action of biguanides is not fully understood. Mainly used in Type II Diabetes, Metformin is considered to increase insulin sensitivity in vivo, resulting in reduced plasma glucose concentrations, increased glucose uptake, and decreased gluconeogenesis.

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, reduce 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[edit]

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, therefore metformin is contraindicated in renal insufficiency. Renal functions should be assessed before starting metformin. 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.

References[edit]

  1. ^ Thomas Güthner, Bernd Mertschenk and Bernd Schulz "Guanidine and Derivatives" in Ullmann's Encyclopedia of Industrial Chemistry, 2006, Wiley-VCH, Weinheim. doi:10.1002/14356007.a12_545.pub2
  2. ^ Rang et al., Pharmacology, 5th Edition, 2003, p 388