The means limiting appetite

rachonnejgyj — Sun, 01 Aug 2010 07:27:51 +0000

The physiological system of regulation of appetite includes the central and peripheral links. To peripheral conditionally carry trailer elements of the flavoring, olfactory and visual analyzers, the sensitive nervous terminations in a digestive path. To central — corresponding kernels гипоталамуса: lateral (the so-called center of hunger) and вентромедиальные (the saturation center). Both centripetal, and centrifugal импульсация in this system extends mainly through серотонинергические (5-HT1B and 5-5-receptors), катехоламинергические (альфа1, бета1 and beta2-adrenoretseptory) and дофаминергические (D1-receptors) media even mechanisms. Substantially appetite depends on a functional condition лимбической systems, a cerebral cortex (especially frontal shares), a fabric metabolism. The important role in appetite regulation сатиетина (the specific alfa1-glycoprotein circulating in blood quashing feeling of hunger) and others эндогенных of substances is established also: холецистокинина, insulin, a glucagon, либераторов kortiko – and тиротропинов, neuropeptid Y, etc.
To appetite stimulation usually apply bitterness, for example wormwood tincture. It doesn’t increase branch of gastric juice. But containing in leaves and stalks of this plant difficult ethers and glycosides (абсинтин), irritating receptors of a mucous membrane of an oral cavity, is reflex raise excitability of the center of hunger. Therefore the subsequent food intake is accompanied by significant strengthening of the first (complex-reflex) phase of secretion of a stomach. Activity raising appetite is inherent in insulin (feeling of hunger the hypoglycemia developing on its background), to some psychotropic substances (хлорпромазин, амитриптилин provokes, lithium a carbonate), нейротропным to hypotensive preparations (clonidine), to anabolic steroids.
The means limiting appetite (анорексигены) use at superfluous weight of a body and the pathological conditions accompanied by raised appetite. On points of the appendix of action two groups of preparations allocate: influencing on катехоламинергическую system and, as a rule, stimulating ЦНС (derivatives фенилалкиламина — амфетамин, амфепрамон and дезопимон, an isoindole derivative — мазиндол), influencing on серотонинергическую system (oppressing ЦНС) derivatives фенилалкиламина (фенфлурамин, дексфенфлурамин).

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Амфетамин (фенамин) has been synthesized more 100 years ago. It possesses peripheral and central (raising) адреномиметической activity and raises локомоторику. Since 30th years of its steel to apply to working capacity increase, and also as a psychostimulator at an adynamy, fatigue, a narcolepsy. However it has appeared that powerful enough psychostimulation is accompanied by undesirable by-effects: increase the HELL, a tachycardia, a sleeplessness, anxiety, and the main thing — development of accustoming and physical dependence. The action mechanism фенамина consists mainly that it strengthens liberation from the nervous terminations of noradrenaline and дофамина and oppresses their return capture. The saturation center that leads to suppression of feeling of hunger is thus raised. As анорексиген амфетамин it is not applied because of an abundance of by-effects (see above). Амфепрамон on structure and action it is similar with фенамином, but concedes to it on ability to reduce appetite. In order to avoid dream infringement this preparation appoint only in first half of day. Others адреномиметики — дезопимон, мазиндол — are excluded now from the Russian state register of medical products.
Preparations with серотонинергическим action differ that possess sedative effect and don’t raise the HELL. They increase liberation серотонина in corresponding синапсах and suppress it нейрональный capture. Strengthening серотонинергической transfers to the food center leads to appetite fall, decreases гиперфагия, provoked by insulin, and also a disturbing condition. At adiposity with infringement of flavoring habits propensity to consumption of carbohydrates (but not fibers) selectively chokes

Besides анорексигенной activity, them, in particular фенфлурамину, direct influence on a metabolism is inherent: glucose mastering by peripheral fabrics amplifies, synthesis триглицеридов decreases (and their absorption in ЖКТ), fats from depot will be mobilized and their catabolism is intensified. Appetite fall can be accompanied by rather serious complications (drowsiness, depression, irritation of mucous membrane ЖКТ, medicinal dependence). Фенфлурамин have ceased to apply in the late nineties because of changes of mitral valves caused by it and the pulmonary hypertensia connected with it. Дексфенфлурамин essentially differs from фенфлурамина that doesn’t cause dependence.
Effective анорексигеном is сибутрамин. It operates in central and noradrenaline – and серотонинергических синапсах, ингибируя return capture of both mediators. In an organism деметилируется also forms the metabolites surpassing initial substance on activity. In parallel with appetite suppression сибутрамин increases термогенез. Reduction of weight of a body is accompanied by decrease in blood of concentration триглицеридов, the general cholesterol, ЛПНП and uric acid against growth ЛПВП. Сибутрамин, as well as дексфенфлурамин, doesn’t lead to development of medicinal dependence.
All preparations of this group aren’t deprived by-effects, and at their application strict medical control is necessary.