Cannabis Flashcards
What are the two main types of cannabinoids?
THC = tetrahydrocannabinol
CBD = cannabidiol
What are the effects of THC?
Psychoactive
Antiemetic
Analgesic
Antispasmodic
Appetite stimulant
What are the effects of CBD?
Anti psychotic
Anxiolytic
Anti epileptic
Anti inflammatory
What are the different routes of administration of cannabis?
Inhalation - smoke, vape
Onset rapid within mins, last 1-3 hours
Topical - local effect
Ingestion - oil, capsule, edible goods, spray (onset mins, last 30-120 mins)
Onset 30-90 mins, last 6-8 hrs
What are drug interactions with CBD?
CBD is inhibitor of CYP3A4 and CYP2D6
Increase serum concentration of:
CCB
Beta blockers
Sratins
SSRIs
TCAs
Antipsychotics like Haldol
Opioids
Benzos
Antihistamines
What are negative effects of cannabis?
Dry mouth, dizzy, drowsy
Change in appetite
Depth perception
HA
Change BMs
STM and attention
Palpitations
Postural HOTN
Psychosis, schizophrenia
Worsen anxiety, depression
Risk of stroke, CVE
What are symptoms of cannabis intoxication?
Anxiety/panic
Tachycardia
N/V
Paranoia
Psychosis
What are signs of cannabis withdrawal?
Irritability/anger
Disturbed sleep
Depressed mood
Loss of appetite
What are two approved cannabis related drugs?
Nabilone = N/V from chemo
Sativex = MS related anti spasticity drug
What were the results from Cochrane review for cannabinoids in tx of dementia?
Little or no effect on cognition (MMSE)
Little or no effect on BPSD (NPI)
Adverse events poorly reported
What are the CCSMH recommendations on cannabis use in older adults?
- Avoid by OA who have: mental health, SUD, CI, CVD, arrhythmia, CAD, impaired balance, unstable BP
- Evidence of medical use is limited, AE include depth perception, balance and falls, appetite change, CI, arrhythmia, anxiety, panic, psychosis and depression
- Educate pts that they can be more susceptible in AE
- Counsel on risk of functional impairment
- Counsel on potential long term effects like CI and worsening mental health conditions
