Biguanides toxicity

Biguanide toxicity is primarily managed by supportive means. Its elimination from the body could be enhanced by dialysis or enhancing excessive urination. 

This preservative is also comparatively new to ophthalmic formulations and has been used as a disinfectant in contact lens solutions. Polyaminopropyl biguanide (polyhexamethyl biguanide) also is a polymeric compound that has a low toxicity potential at the concentrations generally used in these solutions [141, 149, 150]. 

Adverse effect Lactic acidosis due to biguanides Dose-relation toxic effect Time-course time-independent Susceptibility factors genetic (slow phenformin metabolizers) age disease (impaired liver, kidney, or cardiac function, alcoholism)... 

Thiazolidinediones Pioglitazone (Actos) Rosiglitazone (Avandia) Similar to the biguanides (metformin) Headache dizziness fatigue/weakness back pain rare but potentially severe cases of hepatic toxicity... 

Chlorhexidine Bis-biguanide Good antibacterial activity, low sensitizing potential and toxicity ... 

Adverse effect Lactic acidosis due to biguanides Dose-relation toxic effect Time-course time-independent... 

Chlorhexidine diglnconate is a biguanide surfactant with low toxicity, bnt it is a strong contact sensitizer. Its mncns-binding capacity hmits its nse it binds to hydrophilic (soft) contact lenses. BnUd-up of proteinaceous debris in lenses may greatly increase the binding of chlorhexidine to the lens. 

Dr. Louis Friedman (U. S. Vitamin) In reference to Dr. McMahons report on the molecular modification in sulfonylureas, I think mention should be made of similar work in modification of biguanide, which, as you know, forms another clinical compound of utility in the treatment of diabetes. It is interesting to note, in commenting on the question of toxicity in man and animals, that Taubman and his associates in 1919 found that lower alkyl biguanides were too toxic in animals and recommended that they not be used in man. 

The other members of this family of compounds are phosphorodithioic acid derivatives. Of these, menazon, 0,0-dimethyl-S-(4,6-diamino-l,3,5-triazin-2-yl)-methyl phosphorodithioate (78), distinguishes itself by its low toxicity to warmblooded animals. It is prepared by cyclisation of biguanide and ethyl chloroacetate, upon which the 2-chloromethyl-4,6 iaminotriazine formed is reacted with sodium 0,0-dimethyl phosphorodithioate (Anonym, 1958). 

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