cannabis pharmacology

Question 1

uses for medial marijuana

Answer 1

control nausea/vomiting, analgesic
reduce intraocular pressure, anticonvulsant, appetite stimulant, withdrawal from depressants and opioids

Question 2

what are cannabinoid drugs

Answer 2

cannabidol– seizures
dronabinol, nabilone– nausea/vomiting in cancer
nabiximols- neuropathic pain, MS spasticity

Question 3

THC vs CBD

Answer 3

THC: psychoactive, partial agonist, targets CB1/CB2
CBD: non-psychotropic, low affinity for CB1/CB2

Question 4

___ decreases THC clearance by CYP inhibition

Answer 4

CBD

Question 5

solubility of THC

Answer 5

low solubility
high lipophilicity

Question 6

overdose from THC?

Answer 6

no documented fatalities

Question 7

THC/CBD precursor

Answer 7

CBG

Question 8

onset/duration smoked versus PO

Answer 8

smoked: onset 1-2 minutes, duration 4 hours
PO: onset 30 minutes, duration 6 hours

Question 9

positive/negative effects

Answer 9

positive: euphoria, relaxation, laughing, appreciation for music
negative: anxiety, fear, paranoia, panic, hallucinations (rare)

Question 10

acute effects

Answer 10

dry mouth, stim appetite, antiemetic at low dose, n/v at high dose, inc HR, orthostatic hypotension, red eyes (dilate blood vessels)
impairs attention, short term memory, some complex cognitive processes, motor abilities

Question 11

long term effects

Answer 11

impaired cognition: attention, memory, problem solving, mental flexibility
altered brain function on neuroimaging: prefrontal cortex, cerebellum, hippocampus

Question 12

symptoms of cannabis withdrawal

Answer 12

craving cannabis
sleep difficulties, irritability, anxiety

Question 13

marijuana is ____ soluble

Answer 13

fat soluble

Question 14

ADME

Answer 14

inhalation: absorption directly through the lungs, onset in a few minutes, peak concentrations 30-60 minutes, drug effects for 2-4 hours.
lipid soluble: deposits in tissues of fatty organs such as brain, lungs, kidneys, liver (even when blood levels of THC are zero, levels can be substantial in other organs

Question 15

oral ingestion is_____ compared to inhaled

Answer 15

slower, inefficient: onset can take up to an hour, drug effects can be experienced for longer periods of time (4-6 hours), the dose needed to create a comparable high is 3x greater

Question 16

THC is capable of crossing ____

Answer 16

placenta and reaching fetus

Question 17

general THC concentration following ingestion

Answer 17

THC absorbed through lungs causes rapidly rising levels of THC in blood plasma
after peak levels reached, plasma THC levels begin to decline
metabolism by liver
accumulation of drug in fat stores

Question 18

THC metabolism

Answer 18

metabolized twice by liver enzymes CYP2C9

Question 19

when does tolerance occur

Answer 19

when high doses are used over extended periods of time

Question 20

why can you overdose on opioids, cocaine but not marijuana

Answer 20

receptors for anandamide are found in several regions of the brain, but not much in the brainstem (as compared to receptors for opioids and cocaine)

Question 21

mechanism

Answer 21

main target: presynaptic endocannabinoid CB1 receptor: presynaptic inhibition of GABA neurons, disinhibition of dopamine neurons, increase dopamine release

Question 22

describe the parts of the endocannabinoid system

Answer 22

receptors: cannabinoid receptor 1 & 2 (CB1, CB2)
endocannabinoids: anandamide, 2-AG
enzymes: fatty acid amide hydrolase (FAAH)

Question 23

where is CB1 expressed

Answer 23

central nervous system

Question 24

where is CB2 expressed

Answer 24

peripheral immune cells

Question 25

the psychoactive & reinforcing effects come from ___

Answer 25

CB1