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Neurology > Cannabis Pharmacology > Flashcards

Cannabis Pharmacology Flashcards

1
Q

What can Medical Marijuana do?

A
  • Reduces intraocular pressure
  • Control of nausea and vomiting
  • Anticonvulsant
  • Appetite stimulant
  • Withdrawal from depressants and opioids
  • Analgesic
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2
Q

Epidiolex (Cannabidol)

A
  • By FDA on June 25th, 2018
  • Seizures, spasticity, neuropathic pain
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3
Q

Dronabinol (Marinol)

A
  • Nausea, vomiting for patients in cancer
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4
Q

Nabilone (Cesamet)

A

Nausea, vomiting for patients in cancer

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5
Q

Nabiximols (Sativex)

A

Neuropathic pain, spasticity in patients with mutliple sclerosis

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6
Q

Tetrahydrocannabinol (THC)

A
  • Partial agonist
  • Targets CB1/CB2
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7
Q

Cannabidiol (CBD)

A
  • Non-psychotropic, low affinity for CB1/CB2
  • Anxiety, cognition, movement disorders, and pain
  • Decreases THC clearance * (likely by CYP inhibition)
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8
Q

CBN

A
  • THC metabolite
  • CB2-selective partial agonist
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9
Q

CBG

A
  • THC/CBD Precursor
  • CB1/2 antagonist
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10
Q

Tetrahydrocannabinol (THC) - Pscyhoactive

A
  • Low toxicity (LD50 = 1270 mg/kg in adult male rats)
  • Low solubility, high lipophilicity (Log P > 6000 by shake flask, 2.9 ug/mL in H20)
  • No documented overdose fatalities * from THC*
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11
Q

What are the potential positive effects of cannabis use?

A
  • Euphoria
  • Relaxation
  • Laughing
  • > appreciation for music
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12
Q

What are the potential negative effects of cannabis use?

A
  • Anxiety, fear, paranoia, or panic
  • Hallucinations (rare)
  • Dissipate with time
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13
Q

What are the acute effects of cannabis?

A
  • Dry mouth
  • Stimulated appetite (munchies)
  • Antiemetic (low doses)
  • Nausea and vomiting (high doses)
  • Increased heart rate
  • Orthostatic hypotension
  • Dilate blood vessels (red eyes)
  • Impaired:
    • Attention
    • Short term memory
    • Some complex cognitive processes
    • Motor abilities
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14
Q

What are the long term effects of cannabis?

A

Impaired cognition
* Attention
* Memory
* Problem Solving
* Mental flexibility

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15
Q

Where does cannabis alter brain functioning on neuroimaging?

A
  • Prefrontal cortex
  • Cerebellum
  • Hippocampus
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16
Q

What are some symptoms of cannabis withdrawal?

A
  • Sleep difficulties
  • Insomnia
  • Feeling angry and/or aggressive and/or irritable
  • Feeling anxious, “nervous”
17
Q

Marijuana

A
  • Marijuana is fat soluble
  • Effects may persist or reoccur for 12-24 hours
18
Q

What is the PK of marijuana?

A
  • Absorption directly through the lungs
  • Peak concentrations occur 30-60 minutes later
  • Duration: 2-4 hours
19
Q

What is the PK of THC?

A
  • Lipid-soluble and can deposit in the tissues of fatty organs such as the brain, lungs, kidneys, and liver
  • Even when blood levels of THC are zero, levels of THC in other organs can be substantial
  • Most metabolites (by liver) are excreted slowly through the feces and urine (first pass metabolism)
20
Q

What is the MOA of THC?

A
  • Main target is the presynaptic endocannabinoid CB1 receptor
  • Presynaptic inhibition of GABA neurons
  • Disinhibition of dopamine neurons
  • Increase dopamine release
21
Q

What are the receptors, endocannabinoids, and enzymes of the Endocannabinoid System?

A
  • Receptors: Cannabinoid Receptor 1 (CB1) and Cannabinoid Receptor 2 (CB2)
  • Endocannabinoids: Anandamide, 2- Arachidonoylglycerol (2-AG)
  • Enzymes: Fatty acid amide hydrolase (FAAH)
22
Q

Where is CB1 expressed?

A

CNS

23
Q

Where is CB2 expressed?

A

Peripheral immune cells

24
Q

How does CB1 interact with the brain?

A
  • Dose and time dependent
  • Pscyhoactive and reinforcing effects
  • Euphoria: Increased dopamine in reward center
25
Q

What is a possible treatment for cannabis use disorder (CUD)?

A
  • No strong evidence for any medication
  • No approved medications for CUD
  • N-acetylcysteine (glutamate)

Neurology (21 decks)

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