DIGESTANTS, CARMINATIVE,

APPETITE SUPPRESSANTSRVS

Chaitanya Koppala

APPETITE SUPPRESSANTANOREXIA

Energy intake > Energy expenditure stored as adipose

AppetiteSatiety

Absorption

Metabolic rateThermogenesisPhysical action

Genetic Factors

Energy expenditure↓

Environmental Factors

Energy intake ↑

Neuroendocrine regulation

OBESITY

•Psycological aspect•Cultural &

Socioeconomic aspects

•Hormones•

Neurotransmitter• Enzymes •Receptors

•Total caloric content•Composition of the

diet

•Resting metabolic rate

•Thermo genesis•Physical activity

NEUROPEPTIDES OREXIGENIC ANOREXIGENIC

Central NPY Cocaine Dopamine Amphetamine

Histamine Noradrenaline Peripheral Gherlin Leptin Dynorphin Insulin

CLASSIFICATION

CENTRALLY ACTING ADRENERGIC AGENTS- Benzphetamine,phentermine,diethylpropion,mazidol,phendimetrazine,phenylpropanolamine.

SEROTONERGIC AGENTS: Dexfenfluramine, Fenfluramine, Floxetine

ADRENERGIC-SEROTONERGIC AGENTS- Sibutramine

CARMINATIVES “Promotes expulsion of gases from the Gastro intestinal tract and give a feeling of warmth and

comfort in the epigastrium”

Sodium bicarbonate 0.6-1.5gPeppermint oil- 0.06-0.1 mlCardomom tincture – 1-2 mlOil of Dil- 0.06-0.2 mlGinger tincture -0.6-1.0 ml

Sodium bicarbonate reacts with acid and form Carbon dioxide which distends stomach relaxes LES ( lower esophageal sphincter) followed by eructation (reflex that expels gas noisily from the stomach through the mouth)

Other contains volatile oils which give irritant action with motility and relaxation of lower esophageal sphincter which ends with warmth feeling and comfort

USES:DyspepsiaDiscomfort in the upper abdomen Gas formation Feeling of fullnessBurning sensation

DIGESTANTS OR APPETITE STIMULANTSThese are substances intended to promote digestion of food. A number of proteolytic, amylolytic and lipolytic enzymes are marketed in combination formulations.Vigorously promoted for dyspeptic symptoms, and as appetite stimulants or health tonics. They are occasionally beneficial, only when elaboration of enzymes in g.i.t. is deficient. Their routine use in tonics and appetite improving mixtures is irrational.

1. Pepsin May be used along with HCl in gastric achylia due to atrophic gastritis, gastric carcinoma, pernicious anaemia, etc.2. Papain It is a proteolytic enzyme obtained from raw papaya. Its efficacy after oral ingestion is doubtful. 3. Pancreatin: It is a mixture of pancreatic enzymes obtained from hog and pig pancreas. It contains amylase, trypsin and lipase, and is indicated in chronic pancreatitis or other exocrine pancreatic deficiency states.Fat and nitrogen content of stools may be reduced and diarrhoea/steatorrhoea may be prevented. It has to be used as enteric coated tablets or capsules to protect the enzymes from being themselves digested in stomach by pepsin.

4. Diastase and Takadiastase These are amylolytic enzymes obtained from the fungus Aspergillus oryzae. They have been used in pancreatic insufficiency.

5. Methyl polysiloxane (Dimethyl polysiloxane, Simethicone, Dimethicone) It is a silicone polymer—reduces surface tension and collapses froth, ‘antifoaming agent’. It is not absorbed from g.i.t. and is pharmacologically inert. Added to antacid, digestant and antireflux preparations, it is briskly promoted as a remedy for ‘gas’, a very common gastric complaint.It is also claimed to coat and protect ulcer surface, to aid dispersion of antacids in gastric contents, and to prevent gastroesophageal reflux.