L17

Question 1

cannabis

Answer 1

genus of flowering plant.

Question 2

bioactive compounds in cannabis

which one is man psychoactive compound

Answer 2

tetrahydrocannabinol (THC) and cannabidiol (CBD).

THC is the primary psychoactive compound in cannabis.

Question 3

cannabinoids=

Answer 3

class of chemical compounds that act at the cannabinoid
receptors.

Question 4

terpenoids

Answer 4

non-cannabinoid constituents,

give plant characteristic smell.

Question 5

In vitro and in vivo studies found some terpenoids to have anti-____, anti-___ and anti ___ effects

do clinical trials support this?

Answer 5

In vitro and in vivo studies found some terpenoids to have anti-inflammatory, anti-bacterial and anti anxiety effects, but no clinical trials
to support this

Question 6

Possibility of____ between
compounds.

May explain ____ in experience based on
strains, makes harnessing clinical utility very____

Answer 6

synergy

differences
difficult

Question 7

absorption, aka____ =

Answer 7

bioavailability

fraction of an administered drug that
reaches effectors (plasma, central nervous system)

Question 8

most pharmacokinetic information relates to____, only

Answer 8

THC

Question 9

• smoking provides rapid and efficient delivery from ___ to the___.
Bioavailability of smoked THC is___%, reaching peak plasma concentration in ____ minutes.
•when ingested, bioavailability around ___%, time to peak plasma
concentration is ____ hours

Answer 9

• smoking provides rapid and efficient delivery from lungs to the brain.
Bioavailability of smoked THC is 25%, reaching peak plasma concentration in 6-10 minutes.
•when ingested, bioavailability around 6%, time to peak plasma
concentration is 2-6 hours

Question 10

THC is highly ___ so rapidly taken up by tissues with high

____ flow, including heart, lungs, brain and liver.

Answer 10

THC is highly lipophilic so rapidly
taken up by tissues with high
blood flow, including heart, lungs,
brain and liver.

Question 11

• Tissues with less blood flow accumulate THC more ____ and
release it over a ____ period of
time (i.e. adipose tissue)

Answer 11

• Tissues with less blood flow
accumulate THC more slowly and
release it over a longer period of
time (i.e. adipose tissue)

Question 12

THC stored in __ in chronic, frequent cannabis smokers can be released into the blood for
____

Answer 12

Fat

days

Question 13

THC metabolism mostly done where by what

what metabolites produced

Answer 13

liver
cytochrome P450 2C9
OH-THC and THC-COOH

Question 14

•Within 5 days, ___-___% of a THC dose
is excreted, primarily as __,
65% in __ and 25% in __

Answer 14

•Within 5 days, 80-90% of a THC dose
is excreted, primarily as metabolites,
65% in feces and 25% in urine

Question 15

detect THC in urine ___ days for low dose THC,

can extend to
___ in chronic daily cannabis
smokers (because THC is ___
can accumulate in adipose tissue)

Answer 15

detect THC in urine 2-5 days for low dose THC,

can extend to
weeks in chronic daily cannabis
smokers (because THC is lipophilic
can accumulate in adipose tissue)

Question 16

What type of protein receptors are cannabinoid receptors

Answer 16

inhibitory
G-protein coupled receptors (Gi
coupled)

Question 17

cannabinoid receptors come in two

flavors:

Answer 17

CB1 and CB2

Question 18

CB receptors leads to decrease in
____ accumulation which inhibits
the influx of ____ in the firing neuron
and inhibits neurotransmitter release.

Answer 18

cAMP

Ca2+

Question 19

decrease synaptic transmission,

____ neurotransmitter release

Answer 19

decrease synaptic transmission,

inhibit neurotransmitter release

Question 20

THC is a ____ agonist at

___

Answer 20

THC is a partial agonist at

CB1

Question 21

cannabidiol (CBD)

mechanism of action

Answer 21

negative allosteric
modulator at CB1 (binds
outside the binding pocket to
block receptor activation)

Question 22

CBD can blunt ____

effects of ___

Answer 22

CBD can blunt psychotropic

effects of THC

Question 23

•CB1 receptors are among the most abundant ____.

Answer 23

•CB1 receptors are among the most abundant GPCRs.

Question 24

•CB1 receptors found in __,__,___
•CB2 receptor distribution mostly on __ ___
Pharmacodynamics

Answer 24

•CB1 receptors found in brain, peripheral organs (heart liver fat
stomach, testes) and peripheral nerves.
•CB2 receptor distribution mostly on immune cells.
Pharmacodynamics

Question 25

• Preclinical research suggests CBD has ___ ___ for management of inflammation, anxiety, emesis, nausea, inflammatory pain, and epilepsy. May influence effects of ___. Clinical data ___ for these claims.

Answer 25

• Preclinical research suggests CBD has therapeutic potential for management of inflammation, anxiety, emesis, nausea, inflammatory pain, and epilepsy. May influence effects of THC. Clinical data lacking for these claims.

Question 26

• no documented evidence of a death that can be exclusively attributed to overdosing with cannabis, probably because ___ of ___ receptors in the brain stem region that controls ___ and ___ systems.

Answer 26

• no documented evidence of a death that can be exclusively attributed to overdosing with cannabis, probably because sparsity of CB1 receptors in the brain stem region that controls respiratory and cardiovascular systems.

Question 27

-a lot of correlative data suggesting _____ are more likely to use cannabis, and early cannabis use dose-dependently predicts the development of _____ later on.

Answer 27

-a lot of correlative data suggesting schizophrenics are more likely to use cannabis, and early cannabis use dose-dependently predicts the development of schizophrenia later on.

Question 28

schizo studies do not indicate causation. Does not take into account reverse causality (people with __ __)are more likely to use cannabis), bias, and confounding variables (i.e.: some other unknown factor increase risk of both cannabis use and psychosis leading to spurious associations).

Answer 28

existing psychosis

Question 29

Majority of people who use cannabis do/do not develop schizophrenia. However, cannabis can/can't elicit acute psychosis, can worsen course of _____schizophrenia, and may be a trigger in the development of schizophrenia in at-risk populations. (ie __ ___)

Answer 29

do not can pre-existing genetic predisposition

Question 30

Psychological dependence =

Answer 30

compulsive drug-seeking behavior uses the drug receptively for personal satisfaction, often in the face of known risks to health

Question 31

Physiological dependence =

Answer 31

Physiological dependence = revealed when withdrawal of the drug produces symptoms and signs that are frequently opposite of those sought by the user

Question 32

Cannabis withdrawal is hard/mild, short/long lasting symptoms long term users and other effects

Answer 32

relatively mild and short-lived. Symptoms of restlessness, irritability, mild agitation, insomnia, nausea, and cramping. May be worse in chronic, long-term users, and may contribute to continued drug use

Question 33

Addiction | Diagnosed by __ diagnostic criteria.

Answer 33

the inability to control the use of legal or illegal substances despite negative consequences 11

Question 34

severity of the substance use disorder is determined by the ____ of criteria the person meets (2/11 = mild; 4/11 = moderate, 6+/11 = severe)

Answer 34

severity of the substance use disorder is determined by the number of criteria the person meets (2/11 = mild; 4/11 = moderate, 6+/11 = severe)

Question 35

Approximately _% of those who use cannabis | develop a substance use disorder **

Answer 35

9

Question 36

Synthetic cannabinoids:

Answer 36

a manufactured compound whose properties imitate those of the active constituents of cannabis

Question 37

``` why synthetic cannabinoids? •increased __ •___ off target effects • ___ dosing •better ___ studies ```

Answer 37

``` why synthetic cannabinoids? •increased specificity •decreased off target effects • easier dosing •better controlled studies ```

Question 38

Nabilone:

Answer 38

synthetic analog of THC

Question 39

Dronabinol:

Answer 39

``` (-) trans isomer of △9- THC, approved for nausea and vomiting in patients who undergo chemotherapy and anorexia in AIDS wasting syndrome. ```

Question 40

Nabilone and Dronabinol | how are they taken and why

Answer 40

partial agonists at the CB1 receptor orally. Oral THC analogs have less psychotropic effects than cannabis.

Question 41

Nabiximols (Sativex): ____ drug (cannabis ___) • 1:1 mixture of ___ and ___, sublingual spray • first licensed in Canada for relief of pain in adult patients suffering from __ or ___. • Less ___ effects than smoked cannabinoids.

Answer 41

``` Nabiximols (Sativex): Botanical drug (cannabis extract) • 1:1 mixture of THC and cannabinol, sublingual spray • first licensed in Canada for relief of pain in adult patients suffering from multiple sclerosis or cancer. • Less psychotropic effects than smoked cannabinoids. ```

Question 42

• Rimonabant is an ____ agonist at the ___ receptor • originally approved for the treatment for ___, but later withdrawn due to serious adverse effects (__ and __ __)

Answer 42

``` • Rimonabant is an inverse agonist at the CB1 receptor • originally approved for the treatment for obesity, but later withdrawn due to serious adverse effects (depression and suicide ideation) ```

Question 43

• Cannabinoid receptors exist because

Answer 43

we have endogenous cannabinoids (“endocannabinoids”) that mediate mood, feeding, motor function

Question 44

2 flavours of endocannabinoids

Answer 44

anandamide (AEA) and | 2-arachinoyl glycerol (2-AG)

Question 45

Endocannabinoid synthesis

Answer 45

AEA and 2-AG are made from the phospholipid bilayer of the cell membrane

Question 46

AEA and 2-AG are ___ | neurotransmitters

Answer 46

retrograde

Question 47

In contrast to most neurotransmitters (i.e. glutamate, GABA), AEA and 2AG are/are not stored in vesicles, but rather synthesized __ ___ when and where they are needed.

Answer 47

On demand

Question 48

Endocannabinoids increase/decrease nueronal release of other nt

Answer 48

decrease

Question 49

synthesis of AEA and 2-AG stimulated by produced only in __ regions of brain

Answer 49

increase in conc of intracellular ca when postsynaptic neuron gets depolarized active

Question 50

AEA and 2AG are rapidly cleared from the synapse and inactivated by ___ or ___. ____ of these enzymes prolongs the activity of endocannabinoids

Answer 50

AEA and 2AG are rapidly cleared from the synapse and inactivated by fatty-acid amide hydrolase (FAAH) or monoacylclycerol lipase (MAGL). Suppression of these enzymes prolongs the activity of endocannabinoids

Question 51

Because AEA and 2AG are synthesized and released on demand at the site of action, ___ of AEA or 2AG metabolism would enhance CB1 activation where AEA and 2AG levels are ___, not globally throughout the brain

Answer 51

Because AEA and 2AG are synthesized and released on demand at the site of action, inhibition of AEA or 2AG metabolism would enhance CB1 activation where AEA and 2AG levels are highest, not globally throughout the brain

Question 52

FAAH/MAGL inhibitors do not produce typical ____ effects of THC, sedation, catalepsy, or hypothermia, but do have ____ effects. • several compounds under development for the treatment of __ ___

Answer 52

FAAH/MAGL inhibitors do not produce typical psychoactive effects of THC, sedation, catalepsy, or hypothermia, but do have analgesic effects. • several compounds under development for the treatment of chronic pain

Question 53

BUT, recent clinical trial of FAAH inhibitor | ____ halted, because of several ___ ___ ___

Answer 53

BUT, recent clinical trial of FAAH inhibitor (BIA-2474) halted, because of several severe adverse events

Question 54

Acute effects are ____ and usually associated with ____ doses of THC Eg. panic attacks, severe anxiety, psychosis, paranoia, convulsions,hyperemesis

Answer 54

Rare, high

Question 55

prenatal effects: cannabis use may lead to ___ and ____ changes in offspring. Fetal growth affected (particularly ____), but dose-response relationship is/not identified.

Answer 55

• prenatal effects: cannabis use may lead to neuroanatomical and behavioural changes in offspring. Fetal growth affected (particularly neurodevelopment), but dose-response relationship not identified.

Question 56

• lung cancer: particularly through ____ cannabis • driving: driving while intoxicated seems to increase/decrease the risk fo being in a motor vehicle accident. THC impairs perception, psychomotor performance,

Answer 56

• lung cancer: particularly through smoked cannabis • driving: driving while intoxicated seems to increase the risk fo being in a motor vehicle accident. THC impairs perception, psychomotor performance,