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BB 2 > Cannabis > Flashcards

Cannabis Flashcards

1
Q

What are some environmental triggers for MS

A

Infection (EBV, HERV)
Vitamin D levels
Smoking

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2
Q

What is the major gene of MS

A

HLA-DR

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3
Q

Briefly state mechanism behind MS

A

Autoimmune mediated CNS confined disease of demyelination

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4
Q

What glial cell does MS affect

A

Oligodendrocyte

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5
Q

What is seen in a brain of somebody with MS

A
  • MS plaques
  • Mononuclear cell infilitration
  • Lesions
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6
Q

What is meant by ‘lesions in space and time’

A 
Space= lesions are in different places throughout the brain
Time= lesions are different ages
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7
Q

What is the first lesion in MS associated with?

A

Where inflammation occurs around the blood vessel- immune system is not working

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8
Q

What courses can MS follow

A
  • Relapsing and remitting
  • Secondary progressive
  • Primary progressive
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9
Q

Which course of MS can’t be treated

A

Primary progressive

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10
Q

What is second lesion in MS associated with

A

Demyelination

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11
Q

What are shadow plaques associated with

A

Repear

Shorter node of Ranvier and thinner myelin

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12
Q

What happens if you don’t remyelinate the nerve

A

Vulnerable to death because no myelin is very damaging to cells- fired to death

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13
Q

What are the earliest features of MS (pre active lesion)

A

Activated microglial accumulates

Alerts the vasculature

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14
Q

What are the features of an active lesion

A

Lymphocytes arrive through blood vessel

Form an acute lesion

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15
Q

What are the features of a chronic active lesion

A

Lymphocytes eat out
Active rim is present- seen on MRI
Macrophages full of lipid droplets on edge

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16
Q

What are the features of a chronic inactive lesion

A

Demyelination
Astrocytes move in and form scar- gliosis
OR oligodenrocyte precusor cells move in and form a shadow plaque
OR axonal loss/ death

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17
Q

What happens to ventricles in MS

A

They expand due to accelerated rate of nerve loss

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18
Q

What is main aim of treating MS

A

Prevent lesions from arising in the nervous system

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19
Q

2 approaches to treat MS

A

Escalation- drugs with low efficacy but low side effects, if disease still active switch to drugs with high efficacy high side effects
Induction therapy- a few treatments of highly effective drugs which you watch and monitor. After a few cycles some people don’t seem to need drugs

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20
Q

What happens if people accumulate damage and deficits

A

Start to display signs and symptoms

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21
Q

What are signs and symptoms due to

A

Conduction block
Demyelination
Loss of axons and neurons
Loss of synaptic plasticity

22
Q

What are the signs and symptoms of MS

A 
Blindness
Nystagmus
Fatigue
Pain
Tremor
Spasms and spasticity
Bladder problems
Incontinenece
Sexual problems
Motor defects
Cognitive defects
23
Q

What signs and symptoms respond to cannabis

A

Pain

Spasms and spasticity

24
Q

Define spasticity

A

Exaggerated stretch response- if you try to move the limb it will cause a spasm

25
Q

What causes spasticity

A

Damage to circuitry: either too much excitation or too little inhibition

26
Q

How do you treat spasticity if theres too much excitation

A

Nabiximols
Tizanidine
Anti-convulsants

27
Q

What are the side effects of drugs that treat spasticity

A

Sedation

28
Q

How do you treat spasticity if theres too little inhibition

A

Baclofen (GABA agonist)
GABApentin
Benzodiazepines

29
Q

Mechanism of action of baclofen

A

GABAb agonist

30
Q

Mechanism of action of GABAPENTIN

A

GABA analogue ion channel module

31
Q

Mechanism of action of tizanidine

A

alpha 1 adrenergic agonist

32
Q

Namea MS drug that doesn’t work centrally

A

Dantrolene

33
Q

2 drugs used as nerve blockers

A

Botulinum toxin

Intrathecal phenol

34
Q

Where are active ingredients of cannabis found

A

Glandular secretions of female cannabis flower

35
Q

What is the major psychoactive ingredient

A

THC

36
Q

What receptor does TBC bind to

A

CB1 receptor

37
Q

What kind of receptor is CB1 receptor

A

G protein coupled receptor

38
Q

Where is CB1 found

A 
Brain
Adipose Tissue
Muscle
Liver
Gi tract
Pancreas
39
Q

Where is CB2 mainly expressed

A

Immune system

40
Q

What endrogenous compound binds to CB1

A

Endocannabinoids such as anandamide and archidonoyl gllycerol

41
Q

What is the function of the cannabinoid system

A

To regulate synaptic transmission

42
Q

What happens if there is too much excitation to glutamate firing neurone

A

More glutamate fired
Not only binding to glutamate receptors on synaptic cleft, but receptors outside of the cleft
This causes activation of cannaboid
Blocks calcium channels, no calcium entering presynaptic terminal
Modifies over excitation of synapse

43
Q

How does cannabis affect spasticity

A

Causes muscle relaxation

44
Q

What happens in THC is removed from cannabis

A

No longer working

45
Q

What happens if you block cannaboid receptors

A

Makes spasticity worse

46
Q

Give an example of medical cannabis

A

Nabiximols

47
Q

Why isn’t cannabis prescribed in England

A

Too expensive

48
Q

What are the pleasant effects of cannabis

A 
High euphoria
Relaxation
Happiness
Sleepiness
Disorted perception
Slow coordination
49
Q

Unpleasant effects of cannabis

A 
Appetite enhancement
Impaired judgement
Hallucinations delusions
Psychotic symptoms
Reduced motivation
50
Q

Are street or synthetic cannabis more likely to lead to addiction problems

A

Synthetic

BB 2 (28 decks)

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