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Metformien

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Metformien

Bal-en-stokkiemodel van die metformienmolekuul
Chemie
IUPAC naam N,N-Dimethylimido=
dicarbonimidic diamide
Chemiese formule C4H11N5
Molêre massa 129.167 g/mol
CAS-nommer 657-24-9
Farmakokinetika
Biobeskikbaarheid 50–60%[1][2]
Proteïengebonde Minimaal[1]
Metabolisme Nie deur die lewer
Uitskeiding Uriene (90%)
Halfleeftyd 4–8.7 uur

Metformien, wat onder andere onder die handelsnaam Glucophage verkoop word, is die belangrikste eersteliniemedikasie vir die behandeling van tipe 2-diabetes,[3][4][5][6] veral by mense wat oorgewig is.[7] Dit word ook gebruik in die behandeling van polisistiese ovariumsindroom.[8] Dit word soms as 'n byvoegsel gebruik om die risiko van metaboliese sindroom te verminder by mense wat antipsigotika gebruik.[9] Metformien word nie met gewigstoename geassosieer nie[10] en word per mond geneem.[8]

Metformien word oor die algemeen goed verdra. Algemene newe-effekte sluit in diarree, naarheid en maagpyn.[8] Dit het 'n klein risiko om lae bloedsuiker te veroorsaak. Hoë bloedmelksuurvlakke is 'n bekommernis as die medikasie in te hoë dosisse gebruik word of voorgeskryf word aan mense met ernstige nierprobleme.[11][12]

Metformien is 'n biguanied anti-hiperglukemiese middel. Dit werk deur glukoseproduksie in die lewer te verminder, die insuliensensitiwiteit van liggaamsweefsel te verhoog,[8] en GDF15-afskeiding te verhoog, wat eetlus en kalorie-inname verminder.[13][14][15][16]

  1. ↑ 1,0 1,1 Dunn CJ, Peters DH (Mei 1995). "Metformin. A review of its pharmacological properties and therapeutic use in non-insulin-dependent diabetes mellitus". Drugs. 49 (5): 721–49. doi:10.2165/00003495-199549050-00007. PMID 7601013.
  2. ↑ Hundal RS, Inzucchi SE (2003). "Metformin: new understandings, new uses". Drugs. 63 (18): 1879–94. doi:10.2165/00003495-200363180-00001. PMID 12930161.
  3. ↑ Draznin B, Aroda VR, Bakris G, Benson G, Brown FM, Freeman R, et al. (Januarie 2022). "9. Pharmacologic Approaches to Glycemic Treatment: Standards of Medical Care in Diabetes-2022". Diabetes Care. 45 (Suppl 1): S125–S143.
  4. ↑ Cosentino F, Grant PJ, Aboyans V, Bailey CJ, Ceriello A, Delgado V, et al. (Januarie 2020). "2019 ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD". European Heart Journal. 41 (2): 255–323.
  5. ↑ "Metformin Hydrochloride". The American Society of Health-System Pharmacists. Geargiveer vanaf die oorspronklike op 24 Desember 2016. Besoek op 2 Januarie 2017.
  6. ↑ Maruthur NM, Tseng E, Hutfless S, Wilson LM, Suarez-Cuervo C, Berger Z, et al. (Junie 2016). "Diabetes Medications as Monotherapy or Metformin-Based Combination Therapy for Type 2 Diabetes: A Systematic Review and Meta-analysis". Annals of Internal Medicine. 164 (11): 740–751. doi:10.7326/M15-2650. PMID 27088241. S2CID 32016657.
  7. ↑ Cosentino F, Grant PJ, Aboyans V, Bailey CJ, Ceriello A, Delgado V, et al. (Januarie 2020). "2019 ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD". European Heart Journal. 41 (2): 255–323. doi:10.1093/eurheartj/ehz486. PMID 31497854.
  8. ↑ 8,0 8,1 8,2 8,3 "Metformin Hydrochloride". The American Society of Health-System Pharmacists. Geargiveer vanaf die oorspronklike op 24 Desember 2016. Besoek op 2 Januarie 2017.
  9. ↑ de Silva VA, Suraweera C, Ratnatunga SS, Dayabandara M, Wanniarachchi N, Hanwella R (Oktober 2016). "Metformin in prevention and treatment of antipsychotic-induced weight gain: a systematic review and meta-analysis". BMC Psychiatry. 16 (1): 341. doi:10.1186/s12888-016-1049-5. PMC 5048618. PMID 27716110.
  10. ↑ "Type 2 diabetes and metformin. First choice for monotherapy: weak evidence of efficacy but well-known and acceptable adverse effects". Prescrire International. 23 (154): 269–272. November 2014. PMID 25954799.
  11. ↑ Blumenberg A, Benabbas R, Sinert R, Jeng A, Wiener SW (April 2020). "Do Patients Die with or from Metformin-Associated Lactic Acidosis (MALA)? Systematic Review and Meta-analysis of pH and Lactate as Predictors of Mortality in MALA". Journal of Medical Toxicology. 16 (2): 222–229. doi:10.1007/s13181-019-00755-6. PMC 7099117. PMID 31907741.
  12. ↑ Lipska KJ, Bailey CJ, Inzucchi SE (Junie 2011). "Use of metformin in the setting of mild-to-moderate renal insufficiency". Diabetes Care. 34 (6): 1431–7. doi:10.2337/dc10-2361. PMC 3114336. PMID 21617112.
  13. ↑ Coll AP, Chen M, Taskar P, Rimmington D, Patel S, Tadross JA, et al. (Februarie 2020). "GDF15 mediates the effects of metformin on body weight and energy balance". Nature. 578 (7795): 444–448. doi:10.1038/s41586-019-1911-y. PMC 7234839. PMID 31875646.
  14. ↑ Day EA, Ford RJ, Smith BK, Mohammadi-Shemirani P, Morrow MR, Gutgesell RM, et al. (Desember 2019). "Metformin-induced increases in GDF15 are important for suppressing appetite and promoting weight loss". Nature Metabolism. 1 (12): 1202–1208. doi:10.1038/s42255-019-0146-4. PMID 32694673. S2CID 213199603.
  15. ↑ Pappachan JM, Viswanath AK (Januarie 2017). "Medical Management of Diabesity: Do We Have Realistic Targets?". Current Diabetes Reports. 17 (1): 4. doi:10.1007/s11892-017-0828-9. PMID 28101792. S2CID 10289148.
  16. ↑ LaMoia TE, Butrico GM, Kalpage HA, Goedeke L, Hubbard BT, Vatner DF, et al. (10 Maart 2022). "Metformin, phenformin, and galegine inhibit complex IV activity and reduce glycerol-derived gluconeogenesis". Proceedings of the National Academy of Sciences of the United States of America. 119 (10): e2122287119.
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