10. Tobacco Vaping Marijuana Flashcards
Note: Juul is not the same as vaping. The use of tobacco products (vapes) has INCREASED since 2016, its use is greater among older students and those who are non hispanic whites or?
hispanics
Students can become addicted to nicotine which harms the brain (which develops until 25)… Age of increased risk taking and impulsivity is due to incomplete development of the prefrontal cortex (drives executive function) which means adolescents are more vulnerable to initiation to drugs and subsequent?
addiction
There is a so called reward circuit in which nicotinic acetylcholine receptors on various VTA neurons are activated by nicotine causing a net increased release of what in the prefrontal cortex**?
Dopamine = increases pleasure = reward = keeps them wanting more nicotene for the sensation
Nicotene interferes with neuroplasticity (impaired) which leads to alterations in gene expression, cell structure, intracellular signaling, synaptic pruning (removing connections) and axon myelination
MEOW
Nicotine admin in rats caused long term cognitive impairment, showed adolescent smokers had decreased memory and attention, and what later in life?
behavior disturbances (substance abuse/mental health issues)
Lung illness breakout linked to vaping… there are many illicit products, caused likely not from active infection but seems to be acute toxic long injury with onset of days to weeks, demonstrating heterogenous collection of pneumonitis patterns… what is an oil that may cause the lung issue, and is found in nearly all cannabis samples- used as a thickening agent to dilute THC oil?
Vitamin E Acetate
Vitamin E Acetate, along with diacetal (butter flavor), where bad ingredients in vaping, along with endotoxins, fungal glucan, formaldehyde.. 12/20/19 new tobacco age moved from 18-21, and on 1/2/20 sales of what for electronic nicotine systems were discontinued?
Sales of fruit and mint flavored cartridges
Marijuana plants have over 100 chemicals referred to as cannabinoids with the main two being tetrahydrocannabinol (THC) which is responsible for the high and what other one?
Cannabidiol (CBD)
Marijuana is schedule 1, legal to buy in 33 states via medical card with qualifying condition and written recommendation from a licensed donor, the main MOA is it stimulates endocannabinoid receptors, which one?
CB1 (more so than) CB2
Stimulated CB1/CB2 on post synaptic neurons increase Ca2+, activating DAG, then endocannabinoids diffuse into the synaptic spave and bind CB1Rs on presynaptic neurons among them being anandamide (partial agonist) and?
2-arachidonylglycerol (2-AG) -full agonist
The stimulation of presynaptic CB1Rs inhibits AC, causing hyperpolarization and less neurotransmitter release, the actions are terminated by 2AG being broke down by MAG lipase in presynaptic cells and anandamide is broken down by WHAT*** in post synaptic ?
FAAH - fatty acid amide hydrolase
What is an orally administered synthetic 9-THC that has affinity for CB1/2 but less efficacy at CB2, CB1 receptor mediates analgesia, appetite enhancement, muscle relaxations and hormonal actions, indicated for anorexia in AIDS, and chemotherapy induced N/V?
Dronabinol
nabilone THC capsule approved for chemo induce N/V
Adverse effects of Marijuana is sedation, bloodshot eyes, depression, dizziness, tachycardia, hypotension, hallucinations and dry mouth, concerns of SE on intelligence and mental function in younger and is considered a ?
gateway drug? nah
Marijuana has be efficacious in chronic/neuropathic pain such as fibromyalgia, N/V, stimulating appetite, MS, anxiety and PTSD and possible sleep quality, tourettes, parkinsons and?
alzheimers unclear
not good for acute pain, tremor, huntingtons, glaucoma, schizophrenia, depression, cancer
Marijuana is contraindicated in pts with psychosis, substance abuse disorders, CV/respiratory disease, and should be used with caution under age 25, mood disorder, CV disease and ongoing use of high doses of benzodiazepines or?
alcohol
Note: FAAH mutation in patient leads to little fear or anxiety and is insensitive to pain and heals quickly - trials in patients of FAAH inhibitors however has been deadly
MEOW
Cannabidiol (CBD) is the second most abundant cannabinoid, and is legal in hemp form. Usually is admin orally, poor aqueous solubility leads to erratic absorption in GI, oral bioavail is low due to significant first pass metabolism, aerosolized CBD has higher bioavail, CBD rapidly distributes, has high volume of distribution and accumulates in ?
adipose tissue due to high lipophilicity
CBD is extensively metabolized in the liver by 7 CYPS - primarily CYP2C19 and?
CYP3A4
CBD is an inverse agonist at CB1/2Rs, but is and agonist TRPv1 receptor (capsacin), PPARy which inc anti and dec pro inflammatory cytokines, and agonist at 5HT1a, most of the above leads to what in the brain?
Neuroprotection
CBD is well tolerated, does not produce psychoactive effects, has not been shown to have potential for abuse, tolerance, or withdrawal- no effect on embryo development but it does have some potential for drug interactions since it inhibits?
CYP450
CBD is indicated and useful for one thing, which include Dravet syndrome and Lennox Gastaut syndrome, which is what? - Patients were symptom free in some cases after using CBD
EPILEPSY
CBD has also shown benefits in alzheimers, n/v, fragile x syndrome, skin disease, CBD tampons, CBD is generally well tolerated and has a good?
safety profile (SE are usually only due to drug drug interactions)
