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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
A

Orlistat

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
Q

Leptin function

A

hormone marker for obesity and satiety signal

26
Q

Leptin receptor signalin in POMC/CART neurons

4 steps

A
  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
Q

Leptin resistance

A

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
Q

Pramlintide MOA

A

analog of amylin

agonist at amylin receptor

receptor signaling incrases satiey, dec. food intake

29
Q

Metreleptin MOA

long term or short term adiposity?

A

analog of leptin

agonist at leptin receptor

receptor signaling leads to decrease of food intake

*long term adiposity

30
Q

Amylin

long term or short term satiety?

A

slows gastric emptying

inhibits glucagon release

promotes satiety

*short term

31
Q

Phentermine SE

A

BP increase

Tachycardia

CNS:insomnia/restlessness

32
Q

Lorcaserin SE

A

HA

Dizzy

Nausea

Valvulopathy

Carcinogenic possibly

IP week 13 endocrine (8 decks)

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