Marihuana

Question 1

Cannabis Sativa

Answer 1

Plant that is dried and smoked as marihuana

Question 2

Marihuana

Answer 2

General Term to describe dried plant products of the cannabis plant, contains 0.5-11% THC

Question 3

THC(Tetrahydrocannabinol)

Answer 3

Main active ingredient in marihuana and dronabinol

Question 4

Cannabinoid

Answer 4

Chemical class of terpines found only in cannabis plant

Question 5

Hashish

Answer 5

The dried sticky concentrated resin from the plant that contains 3.6% THC but can be as high as 28 %

Question 6

Sinsemilla

Answer 6

The buds and flowering tops of female plants, average 7.5 THC but up to 24%

Question 7

Ganja

Answer 7

From India, Dried tops of female plants, varied concentrations

Question 8

Bhang

Answer 8

Weakest form, made from remainder of plant, ground into powder

Question 9

Blunt

Answer 9

Tobacco pipe that has been emptied of tobacco and filled with marihuana

• Can have synergistic effects with nicotine
• Tobacco paper allows it to burn slower
• Looks more commonplace and acceptable
• Brings more of the smoke to the user

Question 10

Cannabis vs Tobacco

Answer 10

Cannabis use has increased

Tobacco use decreased

Question 11

Potency Marihuana

Answer 11

THC and CBD content increases over the years

Question 12

Cannabinol

Answer 12

Metabolite of THC, and is a weak agonist to the CB receptor

Question 13

Cannabidiol (CBD)

Answer 13

• Not psychoactive
• 5-HT agonist
• Contributes to anxiolytic effects
• Potent anticancer properties such as promoting cell death and decreasing cell migration and invasion
• Low affinity for CB1 but acts as an indirect agonist
• Potentiates THC effects by upregulating the number of CB1 receptors or through another CB1 mechanism
• May increase duration of effect of THC by inhibiting Cytochrome P-450 and 2C enzymes

Question 14

C indica vs C sativa

Answer 14

• Indica has a higher CBD:THC ratio that is 4-5 times higher than sativa
  Higher ratios tend to cause less anxiety as CBD is a cannabinoid receptor antagonist
  Synthetic THC has almost no levels of CBD or CBN which explains differential effects

Question 15

THC distribution in joint

Answer 15

20-40% Mainstream
40-50% Sidestream
20-30% Destroyed by burning
10-15% Cigarette Butt

Question 16

Absorption

Answer 16

Plasma levels peak quickly after smoking
Rapid absorption into brain immediately after smoking and then redistributed in 30 minutes
Oral absorption is slow and incomplete
First pass effect causes more production of metabolites

Question 17

Metabolism

Answer 17

Primary metabolite is 11-OH-THC, which is active and more potent
Converted to THC-OOH and is screened in urine
Highly lipid soluble and stored in fat
THC half life is 20-30 hours, but metabolite half life is 30-60 hours or more!

Question 18

Time Course of Effects

Answer 18

Subjective effects peak after 10-30 minutes
Mild hallucinogenic with some depressant and disinhibiting effects
Renders person into highly suggestible state

Question 19

Physiological Effects

Answer 19

Increased heart rate- interferes with reflexes that maintain cardiovascular homeostasis
Increased workload to the heart
Decreased bloodflow to the brain
Dry mouth and throat
No consistent effect on blood pressure
Reddening of the eyes

Question 20

Effects of Recreational Marihuana Use

Answer 20

Cognitive impairments- especially in those who smoked before 16
Deficits in processing speed, attention, memory and executive function
Higher impulsivity
Altered Brain Structure- Greatest in early users, lower white matter integrity associated with higher impulsivity
Early onset- smoked more marihuana more frequently

Question 21

Experienced Users: Low Doses

Answer 21

High

i. initially stimulating with mild tension
ii. Pleasant feeling of well being
iii. Introspective and tranquil

Question 22

Experienced Users: Moderate Doses

Answer 22

Induces sedation and sleep
Reduces the amount of REM sleep
Sense of well being and dreamy state
Perceptions are distorted
Increased sexual thoughts- explains why people report better sexual experience
Can be suppressed more easily than ethanol
Slowed time perception
Short term memory impaired
Analgesia

Question 23

Experienced Users: High Doses

Answer 23

Paranoid Ideation and panic

Question 24

Psychomotor effects

Answer 24

Tracking a moving object harder due to inability to sustain attention and concentration
- Complex tasks involving memory and cognitive function are most sensitive
Effects can linger for 24 hours
Simulated Flyers: Placebo vs 20 mg THC- THC subjects had more significant errors

Question 25

Receptors

Answer 25

CB1 binding in CNS CB2 binding in the peripheral system Binding sites the highest in frontal cortex, basal ganglia, cerebellum, and hippocampus Located within ascending dopamine pathway, increase DA in mesolimbic area - Most prevalent receptor in the brain - Receptor sites are coupled to Guanine nucleotide binding regulatory proteins (G-coupled)

Question 26

Metabolic Tolerance

Answer 26

None

Question 27

Pharmacologic Tolerance

Answer 27

Cannabinoid induced down regulation and desensitization of CB receptors Rapid receptor internalization following agonist binding and receptor activation - Marihuana is a weak agonist, so uninportant

Question 28

Reverse Tolerance

Answer 28

Experienced users anticipate and therefore enhance symptoms

Question 29

Physical Dependence

Answer 29

``` Human dosing every 4 hours for 10-20 days Withdrawal signs peak at 8 hours Symptoms irritability restlessness nausea vomiting sleep disturbances agression loss of appetite Signs diminish after 3 days Readministering THC relieves symptoms ```

Question 30

Marihuana vs Tobacco

Answer 30

``` Products of smoke Decreases testosterone level and reduces the sperm count lower birth weights panic reactions tachycardia Impairs function of immune system ```

Question 31

Passive Inhalation

Answer 31

Being in a room and inhaling secondhand smoke Used in a defense in court Need to be in a condensed room for 20 minutes before it shows up in urine test

Question 32

Impaired Driving

Answer 32

4000 more potent than alcohol in reducing performance

Question 33

Brain Damage

Answer 33

- No cases of cerebral atrophy due to chronic smoking have been found Poor performance in radial arm maze due to permanent changes in hippocampal neurons primate studies showed no permanent neuronal changes

Question 34

Drug Interactions

Answer 34

Used in combination with other drugs Slows absorption of alcohol- prolongs it effects Speeds absorption of cocaine, leads to significant increases in heart rate and panic May be used to potentiate effects of other drugs like cocaine

Question 35

Dronabinol

Answer 35

FDA Approved Used for chemotherapy Appetite stimulation Side effects: Dizzy, warm feeling, stomach pain, memory loss Efficacy is modest compared to other drugs without psychoactive side effects

Question 36

Nabilone

Answer 36

Synthetic Cannabinoid approved to treat nausea and vomiting, adjunct for treating neuropathic pain Approved for use in wasting syndrome Suppress activity in vomiting cemter

Question 37

Canabidiol (Epidiolex)

Answer 37

Natural chemical in cannabis Pure extract has unique pharmacology Accounts for 40% of cannabinoids in marihuana FDA orphan status for treating dravet syndrome- childhood epilepsy Low affinity for CB1 and CB2 receptors Acts as a direct antagonist to the receptor antagonist Potentiate THC by increasing CB1 receptor density Inverse agonist of CB2 receptor

Question 38

Charlotte's Web

Answer 38

Variant in marihuana that is high in CBD, low in THC Not popular among older users because it lacks the psychoactive effects Appears to be effective in reducing childhood seizures, anxiety, depression

Question 39

Endocannabinoid System- Medical Applications

Answer 39

Target for wasting syndrome, pain, wasting syndrome and obesity - Chronic overstimulation of EC --> stimulation in CB1 receptor--> Increase in appetite - CB1 antagonists can counteract this

Question 40

Rimonaband

Answer 40

Selective CB1 Inverse agonist - Treated obesity Removed for suicidal side effects

Question 41

Synthetic Cannabis

Answer 41

Herbal product marketed as natural incense Thought to contain a mixture of legal herbs, but labs found synthetic cannabinoids Cannabinoids not found but metabolites found in urine - Produces high tolerance and high dependence Increased risk for psychotic reactions Chemical composition still unknown

Question 42

Legalization

Answer 42

Schedule I Cannabis, but oral THC is Schedule II | Decriminalization now sought

Question 43

Perceived Risk vs Use

Answer 43

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