5.9 Pharmacology Of Cannabis-cannabinoids Flashcards
What are the key components of cannabis sativa/indica?
- Delta9-tetrahydrocannabinol
- Cannabidiol
- Cannabinol
How much THC is in hemp?
0.3% or less
What is industry hemp?
Strain of cannabis that is grown for agricultural products such as textiles, seeds, and oils
How much THC does marijuana contain?
15-20% of THC
What is the classification of cannabis under the federal controlled substance act?
Cannabis remains schedule 1
What did Obama do in 2014 regarding legalization of hemp?
Obama signs Farm Bill, allowing hemp to be cultivated for research purposes
What happened in 2018 regarding legalization of hemp?
Farm Bill of 2018 passes, federally legalizing hemp and hemp-derived products, including CBD oil
What is the structure of Delta8-THC?
How is tetrahydrocannabinolic acid (THCA) converted to delta9-THC?
What are perceptual SEs of acute cannabis intoxication?
- Temporal slowing
- Auditory, visual, or tactile illusions
- De-personalization
What are affective SEs of acute cannabis intoxication?
- Euphoria
- Disinhibition
- Anxiety
- Emotional lability
What are physical SEs of acute cannabis intoxication?
- Tachycardia
- Postural hypotension
- Conjunctival injection
- Dry mouth
- Increase appetite
What are cognitive SEs of acute cannabis intoxication?
- Suspiciousness or paranoid ideation
- Impaired judgement
- Impaired rxn time
- Impaired attention
What is the endocannabinoid system (ECS) comprised of?
- Receptors (CB1 and CB2)
- Ligands (anadamide [AEA] and 2-AG)
- EMT, endocannabinoid membrane transporter
- Fatty acid amide hydrolase, FAAH; mono-glycerol lipase, MAGL, diacyl glycerol lipase, DAG
What do endocannabinoid and phtyocannabinoids serve as?
Serve as retrograde regulators of neurotransmission, inhibiting release of GABA and glutamine
What is THC and synethic cannabinoids?
- THC is a partial agonist at CB1R
- Synthetic cannabinoids are full agonists
Which CB receptor is higher in the brain?
- CB1 expression in brain is higher than CB2 receptor expression
- Low levels of respiratory centers of brainstem (<resp depression, coma)
- CB2 on glia
Which CB receptor expression is higher in the periphery?
- CB2 receptor expression»_space; CB1 receptor
- CB2 on lymphocytes (B and T cells)
- CB1 on liver (increase lipogenesis)
- Upregulated in liver fibrosis
What is Marinol (dronabinol)?
- FDA approved synthetic d9-THC in sesame oil
- Schedule 3
- Counter loss of appetite
- Tachycardia, red eyes
What is nabilone (cesamet)?
- FDA approved THC mimetic
- Schedule 3
- Anti-emetic
- Chronic pain (off pain) for fibromyalgia, MS
What are challenges w medical marijuana use?
- Lack of product quality control
- Absence of adequately designed studies for assessing efficacy and ADR
- Highly politicized environment precludes a rational approach
- Growing influence of big tobacco and alcohol industries in cannabis industry
What is the pharmacological profile of cannabidiol (CBD)?
- Low affinity for CB receptors
- May antagonize THC @ CB1
- Promiscuous effects on ECS
- Lacks euphoric effects
What is cannabidiol (CBD) FDA approved for?
FDA approved drug for rare seizure disorders:
- Dravet syndrome
- Lennox-Gastaut syndrome
What is the criteria for cannabis use disorder?
> = 2 criteria
Is cannabis use associated with mental health disorders?
- Extremely difficult to prove and controversial
- Growing evidence for association w several disorders, cause and effect not established
What are risk factors and pathway to psychosis?
Age of use onset and potency appear to be key determinants
What are diagnostic criteria for cannabinoid hyperemesis syndrome?
- Cyclic vomiting/abdominal pain
- Presentation after prolonged, excessive use
- Relief by sustained cessation
- May be associated with pathological bathing (hot showers/baths)
What are the txs of cannabinoid hyperemesis syndrome?
- Cannabis cessation
- Benzos
- Haloperidol
- Capsaicin cream (abdomen)
What is the mechanism of capsaicin for cannabinoid hyperemesis syndrome?
- Substance P activates neurokinin-1 receptors in medullary vomiting center of CNS causing N/V
- Activation of transient receptor potential vanilloid-1 receptor by heat, capsaicin, or acidic conditions causes depletion of substance P
- Chronic cannabis use causes desensitization and downregulation of TRPV-1 receptors
- Topical capsaicin applied to abdominal area provides multiple mechanisms of symptom relief
