Biochemical pathway concepts and applications

Rapid acting diet pills begin working from the minute they are consumed and show results within hours. They contain specially extracted alkaloids that increase thermogenesis and oxidation of fat, even during rest, by increasing the release of norepinephrine, epinephrine, caffiene and cortisol. They also cause lipolysis and burn fat quickly. Some pills contain amphetamines,or amphetamine - mimicing substances, which cause appetite suppression. It regulates bood sugar levels through active ingredients, such as corosolic acid, which is a triterpinoid found in leaves. They also reduce sugar cravings. It is important to know the ingredients and exact dosage of these diet pills to prevent the body from reacting in an unwanted manner through effects that can cause detrimental effects to the health of the individuals.(The Bottom Line about Diet Pills). A study shows that natriuretic peptides are powerful lipolytic agents, contained in subcutaneous adipose tissues. Isoproterenol and LCDs are two drugs that cause increased lipolysis through a natriuretic peptide inducing pathway, at a post receptor pathway. This effect was proved through intravenous administration of atrial natriuretic peptide, which induced the same mobilizing effect that was enhanced by LCD. (Sengenes et. al, 2002). These are a few mechanisms by which diet pills act :("Diabolsecafirecaps," ). * It increases lipolysis (fat breakdown) through enhanced dopamine concentration and thyroid output.Triglycerides are first broken down into fatty acids and glycerol. Degradation and oxidation of fatty acids occurs in the mitochondria only. It is first transported into the mitochondria via a shuttle called carnitine. Fatty acid is then degraded to acetyl CoA by beta oxidation. The acetyl CoA produced as a result enters the citric acid cycle. The more the oxidation of these fatty acids, the greater the amount of adenosine triphospate is formed thus producing lots of energy. The metabolism of fat is regulated through short and long term pathways. In the short term pathway, substrate availability, allosteric effectors and/or enzyme modification bring about negative feedback allowing control. The long term pathway is brought about directly through changes of gene expression which inhibits enzyme synthesis. Diabolic pills effect these normal feedback regulations. Recently, ephedrine has been withdrawn from the market due to its multiple adverse effects, although caffeine continues to be an important ingredient in most diet pills. (Champe, et. al, 2009). * It stimulates the release of the main adrenal fat loss hormones such as epinephrine and norepinephrine. Epinephrine and cortisol activates hormone-sensitive triacylglycerol lipase which hydrolyze triglycerides. (Champe, Pamela C, Harvey, 2009) * Epinephrine also decreasesinsulin levels, thus reducing insulin's gluconeogenic abilities, allowing the body to use stored fat. This is accomplished by the blood sugar lowering effects of these pills. Low sugar levels causes low insulin levels which in turn activates hormone sensitive triacylglycerol lipase that hydrolyze triglycerides, which yield fatty acids and glycerol. Also when there is decreased levels of insulin, glucose does not enter fat and liver cells which prevent glucose derived acetyl-Co A and NADPH needed for the synthesis of fats. Lack of glucose and fat cells additionally reduces the availabitily of alpha-glycerophosphate, which in turn does not allow the body to form triglycerides.(Hendset, et. al, 2005). * It prevents fat loss hormones from being broken down allowing the signals to work continuously. Thyroid hormone causes an increase in the overall rate of energy metabolism in the cells of the body which results in reduced levels of acetyl coA and other intermediates of fat and carbohydrate metabolism thus causing fat mobilization. Epinephrine and norepinephrine directly activate the hormone sensitive triglyceride lipase which causes breakdown of fatty acids and mobilization of fat. Recently, thyroid hormones are also being exploited in the use of diet pills. This can lead to hyperthyrodism and hepatotoxicity. Most herbal diet pills have been investigated to contain undeclared ingredients, such as T3 and T4. (Hendset et. al, 2005). * Enhances the fat loss signal molecule by preventing the messenger molecule called cAMP from being broken down.(Champe et. al, 2009). * Effectively blocks alpha- 2 receptors sites which reduces the non-esterified fatty acids as part of lipolysis. Alpha 2 receptor stimulation increases glucagon level. Glucagon is a hormone secreted by the pancreas, when the human body is in a starved state. This increases blood glucose levels. (Henn, &DeEugenio, 2005). * Changes levels of neurotransmitter which creates an anorectic effect(appetite suppressing). Cocaine and amphetamine regulated transcript reduce food intake and increase energy suppression.A drug, called sibutrimine (meridian) keeps serotonin and norepinephrine in balance. These are two important brain hormones involved in fat metabolism and satiety. (Guyton & Hall, 2010) * Prevents the alpha adrenergic receptors from stopping the fat loss process.("Diabolsecafirecaps"). * Increases the thermogenic (calorie burning uncoupling process). It is a process whereby, heat energy is produced. Diet pills contain lipophilic proton carriers (uncouplers) that increase the permeability of the inner mitochondrial membranes to protons and cause uncoupling of electron transport and phosphorylation. The electron transport chain is thus carried out at a much more rapid rate without letting a gradient be established. Energy is therefore released as heat rather than being used for the synthesis of ATP. Epinephrine and norepinephrine cause uncoupling of oxidative phosphorylation, thus increasing cellular metabolism. This process explains why there is fever accompanied with diet pills that aren't taken according to recommendations.The increases in heart rate are in response to fever, which are sympathetically mediated.(Guyton & Hall, 2010). * Certain deit pills decrease calorie absorption through the production of net osmotic effect. These cause oily stool production, flatulence with discharge, pain and osmotic diarrhea.(Henn, &DeEugenio, 2005). Jack's condition was precipitated by an over dosage of the dietbolica diet pills. These fast acting diet pills work to increase metabolism, which increases heat production. In case of an overload, there is uncoupling of ATP production, generating a great amount of heat, which caused Jack's fever spike. Furthermore, the hypoglycemic effects of the diet pills starve the muscle cells of energy, causing Jack to develop muscle cramps. Moreover, the simultaneous increase in heart rate due to the pill's sympathetic effect caused an increased pulse. Sweating and fast breathing are also mediated through sympathetic stimulation.(Guyton & Hall, 2010). Laboratory diagnosis can yield useful results about the patients condition. Firstly, blood sugar levels need to be tested. Next, Urea, creatinine and electrolytes can reveal useful information about any ionic disturbances in blood. An ECG will tell us about certain detrimental effects that might have been caused to the heart due to excessive adrenergic stimulation. Lastly, thyroid, cortisol and insulin levels need to checked to help treat any hormonal imbalance that might have been caused by the pills. (Guyton & Hall, 2010). Management should be based on the development on symptoms. Blood pressure and heart rate need to be continuously monitored. Steps to be performed include, rehydration, airway protection, and control of mental aberrations, sympathetic symptoms and fever. Propranolol is a beta antagonist and has been used to reverse the sympathetic effects of most diet pills, such as, tachycardia, dysrythimias and other symptoms of excessive catecholamines. (Goldrank& Neal, 2006) If sedation is required, to combat agitation on part of the patient, barbiturates or benzodiazepines have been recommended. Antipyretics bring down fever. However, in cases of thryotoxicosis, high doses or asprin should be avoided, since it contains a risk of exacerbating the condition by displacing T3 and T4 from the its thyroid binding globulin, thereby, increasing free levels of T 3 and T4.(Goldrank& Neal, 2006) Extra corporeal drug removal procedures, for example, plasmaphoresis, can also be used in extreme cases of drug over dosage. (Goldrank& Neal, 2006) After the patient has been stabilized, it still remains part of the duty of a doctor, to council about the adverse effects of diet pills and to discuss safer and healthier methods of losing weight. If the doctor thinks it necessary, a psychiatric consult can also be arranged.