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Endocrine/Nutrition Exam 1 Witt
Endocrine/Nutrition Exam 1 Witt
26
Pharmacology
Graduate
10/26/2010

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Term
eating
thermic effect of food: the increase in energy expenditure observed over the administration of a meal
basal energy
Definition
targets for drug treatment in an energy balance model
Term
certain metabolic processes
body temperature
thirst
hunger
circadian rhythm
Definition
what does the hypothalamus regulate?
Term
emotions
food characteristics
lifestyle behaviors
environmental cues
Definition
external factors that effect body weight
Term
NPY
AGRP
galanin
orexin-A
dynorphin
Definition
central signals that stimulate hunger
Term
alpha-MSH
CRH/UCN
GLP-I
CART
NE
5-HT
Definition
central signals that inhibit hunger
Term
cortisol from the adrenal glands
ghrelin from the stomach
Definition
peripheral signals that stimulate hunger
Term
leptin from adipose tissue
glucose from the liver
CCK, GLP-1, Apo-A-IV, vagal afferents from the small intestine
Definition
peripheral signals that inhibit hunger
Term
leptin
Definition
a hormone that plays a key role in regulating energy intake and energy expenditure, including regulation of APPETITE and METABOLISM
deficiency in rodents produces obesity by 3 mechanism: 1) increased ingestion, 2) decreased thermogenesis, 3) preferential fat deposition
gene is located on chromosome 7
produced by ADIPOSE TISSUE
receptors on hypothalamus in the "satiety center"
Term
[image]
leptin targets 2 adjacent pathways in the arcuate nucleus, the appetite-simulating pathway mediated by neuropeptide Y (NPY) and agouti-related protein (AgRP), and the appetite-suppressing pathway mediated by POMC and CART
Definition
the role of leptin, insulin, and hypothalamic peptides in the regulation of energy balance and fat stores
Term
ghrelin
Definition
a hormone produced by PD1 cells lining the fundus of the STOMACH that stimulates appetite
stimulated by secretion of growth hormone from the anterior pituitary
stimulates food intake by activating NPY/AgRP neurons
receptors are expressed in the arcuate nucleus of the hypothalamus
Term
insulin
Definition
stimulates leptin expression in fat cells
decreases food intake and increases energy expenditure, via the hypothalamus
Term
neuropeptide Y (NPY)
Definition
neuronal signaling peptide that binds to receptors in the hypothalamus
induces appetite-stimulation: increased food intake and decreased energy expenditure
neuronal target of leptin (suppressed by leptin)
Term
POMC
Definition
neuron that stimulates alpha-MSH
activated by leptin and insulin
Term
NE
Definition
increases energy use and decreases appetite
synthesized in the brain stem
Term
dopamine
Definition
contributes to the rewarding aspects of palatable food
arcuate receptors seem to inhibit food intake
Term
serotonin
Definition
suppresses food intake
leptin increases its turnover and may contribute to leptin's weight-reducing effects
Term
pancreatic lipase inhibitor - prevents the break down of ~ 30% of dietary fats to fatty acids and acylglyerols
forms a covalent bond with gastric
used in patients who have high blood pressure, diabetes, high cholesterol (reduces LDL), or heart disease
approved for long term use
excreted in the feces, only very small amount absorbed
ADRs: abdominal cramps, flatus, discharge, fecal incontinence, oily spotting
Definition
MOA and side effects of orlistat
Term
SCOUT report indicated higher risk of heart attack, stroke, and other cardiac problems in patients taking sibutramine
also containing sibutramine: Slimming Beauty Bitter Orange Slimming Capsules
Definition
why was sibutramine withdrawn from the market?
Term
structurally and chemically similar to amphetamines
increases release of NE and inhibits NE reuptake into nerve terminals; considered an indirect-acting symptathomimetic
acts as an appetite suppressant by stimulating the satiety center of the hypothalamic and limbic regions of the brain
secondary actions: CNS stimulation, BP elevation
used for short term (12 weeks) management of obesity
Definition
MOA of diethylpropion
Term
similar to amphetamines, phentermine increases the release of NE and dopamine and inhibits their reuptake
classified as an indirect sympathomimetic
CNS stimulation and increased BP
appetite suppression occurs through direct stimulation of the satiety center in the hypothalamic and limbic regions
used for short term (8-12 weeks) obesity management
tolerance to the anorexiant effects of phentermine develop within a few weeks of therapy; not recommended to increase dose, phentermine should be discontinued
Definition
MOA of phentermine
Term
indirect acting sympathomimetic amine that stimulates the CNS and causes appetite suppression
benzphentamine is metabolized to amphetamine, and therefore has actions as both an indirect sympathomimetic and direct adrenergic agonist.
at typical doses, stimulates release of NE
at high doses, stimulates release of dopamine
at even higher doses, stimulates release of serotonin
causes decreased sense of fatigue, increased motor activity, mental alertness, mild euphoria, increase BP, respiratory stimulation, bronchodilation, cardiac arrhythmias (due to NE release)
HIGH POTENTIAL FOR ABUSE AND ADDICTION
Definition
MOA of benzphentamine
Term
cancer cells release chemicals in the body which induce the breakdown of muscle (lean body mass) and fat stores which results in cancer wasting syndrome
immune cells become activated to fight cancer; immune activation causes the release of cytokines; long term overproduction of cytokines contributes to the breakdown and depletion of lean body mass, fat, and glycogen stores
chemotherapy and radiation therapy leads to loss of lean body mass and fat stores; reduced caloric intake due to N/V
Definition
factors that contribute to cancer wasting
Term
inadequate caloric intake: anorexia, physical conditions, psychosocial and access factors, malabsorption
altered metabolism: opportunistic infections, malignancies, testosterone deficiency
Definition
etiologies of wasting syndrome
Term
schedule III controlled substance
synthetic oral preparation of delta-9-THC
acts as an agonist at endogenous cannabinoid receptors, CB1 and CB2 (GPCR that decrease the excitability of neurons)
CB2 receptor found in periphery and as part of the immune system
CB1 receptor found in the periphery and in the brain
THE APPETITE STIMULATING EFFECTS ARE MEDIATED BY CANNABINOID RECEPTORS IN THE LATERAL HYPOTHALAMUS
approved to treat anorexia and nausea
Definition
MOA of dronabinol
Term
interferes with cachexin, the hormone that inhibits lipogenic enzymes which leads to the wasting syndrome of AIDs and cancer
a systemic oral progestin
an antineoplastic agent
usually causes fat weight gain, not lean fat weight gain
Definition
MOA of megastrol acetate
Term
in people with wasting syndrome, both fat and muscle are lost; losing too much muscle can be a serious problem
protects the muscles in the body and helps form new muscles
can possibly treat lipodystrophy, a side effect of anti-HIV drugs that can cause a build up of fat around the gut, breasts, or back of the neck
helps the thymus produce more T-cells
side effects: muscle/bone pain, swelling of hands/feet, allergic reaction, increased glucose, increased HIV reproduction?
Definition
MOA of growth hormone
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