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IP week 13 endocrine > Obesity > Flashcards

Obesity Flashcards

1
Q

Overweight definition

A

Excessive body weight from ALL TISSUES

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2
Q

Obesity definition

A

Excessive amount of adipose tissue compared with lean tissue

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3
Q

Antiangiogenesis and poangiogeNesisdefinition

A

Look it up

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4
Q

3 FDA requirements for obesity drugs

A

1.5% reduction in total body weight maintained for 1 year OR 2. >35% of patients maintain 5% reduction in weight 3. Improve BP/lipids/blood glucose

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5
Q

Feeding behavior comes from what part of the brain

A

Hypothalamus

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6
Q

3 hormones that increase feeding

A

Neuropeptide Y AGRP Ghrelin

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7
Q

7 hormones that DEcrease feeding

A

a-MSH Lepton NEinsulin/amylin Cholecytokinin (CCK)/PYY CART

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8
Q

Leptin is released because of what

A

In proportion to fat

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9
Q

Pry/insulin/cck are released when

A

Upon digestion

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10
Q

When is ghrelin released

A

During fasting

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11
Q

Appetite Regulation

A
  1. Increase
  2. decrease
  3. increase
  4. POMC/CART
  5. AGRP/NPY
  6. Increase
  7. a-MSH
  8. Neurons of PVN
  9. Neuron
  10. decrease
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12
Q

POMC is produced where?

A

Pituitary

hypothalmush

brainstem

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13
Q

4 steps to decrease feeding

A
  1. Insulin/leptin/CCK are released and bind to receptors on AGRP/NPY or POMC/CART
  2. Leptin receptors release POMC and after enzymatic breakdown created a-MSH which decrased food intake
  3. a-MSH binds to the neuron receptor MCR-4
  4. sympathetic activity and energy expenditure are increased
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14
Q

4 steps to increase feeding

A
  1. Ghrelin is released
  2. Ghrelin stimulates Ghrelin hormone secretagogue receptor on AGRP/NPY
  3. Y1 receptor is stimulated in the neuron
  4. Food intake increased
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15
Q

Paraventricular Nucleus

(PVN)

A

send signals to the lateral hypothalamus to alter taste sensation and control autonomic responses such as digestive secretions

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16
Q

Orlistat (Alli)

5 MOA

2 recommendations

A
  1. inhibit lipase enzymes by binding to serine residues of enzyme active site
  2. prevent hydrolysis of TF to FFA (no activity on amylase/trypsin/chymotrypsin/phospholipases)
  3. TG excreted undigested
  4. REduces absorption of dietary fat
  5. decreases caloric intake

* BMI >30

*Diet that contains 30% calories from fat

17
Q
18
Q

Major SE of Orlistat

A

GAss

malabsorption of fat-soluble vitamins

19
Q

Phenteramine 2 MOA

Duration of action

A

TAAR1 agnost: stimulates NE, 5-HT and DA release in hypothalamus

Stimulates sympathetic response

  • inc. energy
  • Ne activating B2-ARs in synapses inhibit appetite

*3 months

20
Q
A

Phentermine

21
Q

PHentermine & Topiramate (Qsymia)

SE

A

BMI >30

BMI >30 and weight related comorbidity

  • HTN, DM2, Dylipidemia

SE: tertogenic possibly/ inc heart rate

22
Q

Lorcaserin (Belviq)

MOA

A
  1. Agonist selective for 5-HT2c receptor highly expressed in POMC/CART neurons
  2. increses activity
  3. stimulate release of a-MSH
  4. decrease food intake
23
Q
A

Lorcaserin

24
Q

bupropion and naltrexone (contrave)

MOA

A

B: inhibit DA and NE uptake

N: u-opioid receptor antangonist

25
Leptin function
hormone marker for obesity and satiety signal
26
Leptin receptor signalin in POMC/CART neurons 4 steps
1. leptin bindts to receptor causing binding and activation of Janus-family tyrosine kinase 2 (JAK2) 2. JAK2 phosphorylates receptor 3. Recruits binding of signal transducer and activator of transcription (stat) factors 4. stat3 initiates transcription of multiple genes (POMC/a-MSH) \*this pathway required for anti-obesity effect of leptin
27
Leptin resistance
large fat mass yields high circulating levels of leptin inhibition of leptin by suppressor of cytoking signaling (negative feedback) prevents high leptin levels from decrease food intake
28
Pramlintide MOA
analog of amylin agonist at amylin receptor receptor signaling incrases satiey, dec. food intake
29
Metreleptin MOA long term or short term adiposity?
analog of leptin agonist at leptin receptor receptor signaling leads to decrease of food intake \*long term adiposity
30
Amylin long term or short term satiety?
slows gastric emptying inhibits glucagon release promotes satiety \*short term
31
Phentermine SE
BP increase Tachycardia CNS:insomnia/restlessness
32
Lorcaserin SE
HA Dizzy Nausea Valvulopathy Carcinogenic possibly

IP week 13 endocrine (8 decks)

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