Obesity Flashcards
Central body weight regulation
————of the hypothalamus, Regulates appetite, feeding behavior and energy status
Arcuate nucleus (ARC)
The Arcuate Nucleus (ARC) Receives afferent inputs originating from the ———
GI tract
Arcuate nucleus (ARC) Contains receptors for ——- and other hormones
Leptin
fxn: inhibits hunger and regulates energy balance (so that the body doesn’t trigger a hunger response when it doesn’t need energy -calories)
In the ARC, there are two groups of functionally distinct neurons that exert opposite effects on appetite
1) ——— (appetite supressing)
2) ——– (appetite promoting)
1) Anorexigenic (appetite supressing)
2) Orexigenic neurons (appetite promoting)
Anorexigenic nerurons (appetite supressing)
activate what to supress appetite?
1) Pro-opiomelanocortin (POMC)-derived peptides (such as αmelanocyte-stimulating hormone; α-MSH)
2) Cocaine- and amphetamine-regulated transcript (CART)-derived peptides
Orexigenic neurons (appetite promoting), activate what to trigger hunger ?
1) Neuropeptide Y (NPY)
2) Agouti-related peptide (AgRP)
Energy homeostasis depends on the balance between
the actions of —— and ——– in the Arcuate nucleus
Energy homeostasis depends on the balance between
the actions of Anorexigenic neurons and Orexigenic neurons in the Arcuate nucleus
1st line tx for Obesity
GLP1-mimetics (Liraglutide)
2nd line tx for Obesity
Orlistate (when GLP-1 mimetic are not effective/well-tolerated)
3rd line tx for Obesity
Phentermine (Centrally acting drug)
Centrally acting drugs
Phentermine
topiramate
Naltrexon
Bupropion
MoA of Phentermine
Sympathomimetic amine
anorectic effects in hypothalamus and limbic areas of the brain
–> Increases the release of norepinephrine and dopamine (DA) -> increased POMC/CART neuron activity
SOOO, SUPRESES APPETITE
MoA of Topiramate
Anti-epileptic drug that possibly suppresses appetite and enhances satiety
MoA of Bupropion
Increases DA activity in the brain –>reduction in appetite and increase in energy expenditure by increased POMC neuron activity
MoA of Naltrexon
Blocks opioid receptors on POMC neurons–> preventing feedback inhibition of these neurons with
increased POMC activity
GLP-1 mimetics used in the tx of Obesity
liraglutide,
semaglutide
GLP-1 is a regulator of ——– and —–
GLP-1 is a regulator of appetite and calorie intake
[TRUE/FALSE]
GLP-1 mimetics (liraglutide, semaglutide) promote weight loss in patients with or without T2D
TRUE
MoA of Orlistat
Peripherally-acting drug
* Inhibits irreversibly gastric and pancreatic lipases
* Prevents the breakdown of dietary fat to fatty acids and glycerols
* Decreases fat absorption
* Effective in T2D
* Reduces blood pressure
* Delays gastric emptying and gastric secretion
* Does not induce changes in energy expenditure
AE of Orlistat
1) Abdominal cramps,
2) flatus with discharge,
3) faecal incontinence,
4) intestinal borborygmi (rumbling),
5) oily spotting
which drug requires Supplementary therapy with fat-soluble vitamins
Orlistat
Orlistat affects the absoprtion of what drugs?
1) Oral contraceptives
2) Ciclosporin
Drugs that may cause weight gain
1) Anti-diabetics (insulin, sulfonylureas, thiazos)
2) α-blockers
3) β-blockers
4) Steroids
5) TCAs
6) MAOIs
7) Anti-psychotics
8) SNRIs
9) Anti-convulsants (phenytoin, carbamazepine)
drugs that may case weight loss
1) Anti-infective agents
2) Anti-cancer drugs
3) Salbutamol
4) Theophylline
5) Amiodarone
6) Hydralazine
7) Methylphenidate
8) Fluoxetine
9) Galantamine
10) Rivastigmine
11) Sulfasalazine
12) Topiramate
13) Metformin
