biguanideja

Biguanideja, in English commonly referred to as biguanides, denote a class of organic compounds characterized by two guanidine units linked by a central scaffold. The term is used in pharmacology and antiseptic chemistry to describe both therapeutic drugs and antiseptic agents that share the same basic chemical motif.

In medicine, the most widely known biguanide is metformin, used to treat type 2 diabetes. Its primary effects are to suppress hepatic gluconeogenesis, improve insulin sensitivity, and increase peripheral glucose uptake. The mechanism is partly mediated by activation of AMP-activated protein kinase, though the exact pathways continue to be studied. Metformin is typically prescribed as a first-line therapy and is often used in combination with other antidiabetic agents.

Historically, phenformin and buformin were developed as antidiabetic drugs but were withdrawn in many regions due to an increased risk of fatal lactic acidosis, especially in patients with renal impairment or acute illness. This history has shaped the current emphasis on safer, lower-risk biguanides for systemic use.

In antiseptic practice, biguanides include chlorhexidine and polyhexamethylene biguanide (PHMB). These compounds are used for skin disinfection, wound care, oral rinses, and various professional hygiene applications because of their broad antimicrobial activity and relatively favorable safety profile.

Safety and side effects: systemic biguanides such as metformin can cause gastrointestinal upset and, rarely, lactic acidosis, particularly in the context of kidney impairment, dehydration, or excessive alcohol use. They are generally avoided in severe renal dysfunction, and caution is advised with iodinated contrast media.