medical cannabis

Question 1

what is the only natural cannabis product licenced in the UK? use? made up of?

Answer 1

Sativex
for mod-severe spasticity in adult patients with MS
contains 1:1 ratio of THC and CBD

Question 2

cost of sativex?

Answer 2

£120 for 10ml

Question 3

does NICE recommend prescribing sativex?

Answer 3

no

Question 4

what is dronabinol in the UK? is it lisenced? used for?

Answer 4

synthetic product identical to THC
produced in UK but not licensed
sch 2 and prescribed on a named patient basis: N&V due to chemotherapy which is unresponsive to conventional antiemetics

Question 5

what is nabilone. licences? schedule? use?

Answer 5

synthetic product similar to THC
produced in UK and licensed
Sch 2, no restriction on prescribing
Can be prescribed for nausea and vomiting due to chemotherapy which is unresponsive to conventional antiemetics

Question 6

what is epidiolex, lisenced in UK? used for?

Answer 6

cannabidiol (CBD) isolated from cannabis
produced in canada not licensed in UK
rare forms of childhood epilepsy

Question 7

how do doctors feel about the cannabis based products they can prescribe in the UK?

Answer 7

little support, must take responsibility to prescribe

Question 8

restrictions on cannabis products impact on patients?

Answer 8

frustrated and thousands still struggling to manage their conditions
patient-doctor relationships impacted
go to black market?
unaffordable on private prescriptions

Question 9

3 significant potential harms of cannabis

Answer 9

schizophrenia- in combination with other risk factors
memory loss and cognition
addiction

Question 10

withdrawl symptoms of cannabis? when do they stop

Answer 10

irritability

after about 3 days

Question 11

side effects of cannabis? when do they resolve

Answer 11

drop in BP= vomitting, collapse, pale, shakey 
feelings of confusion 
palpitations 
resolve within an hour
not as bad as many other drugs

Question 12

which receptors do endocannabinoids primarily function through?

Answer 12

G-protein coupled receptors: CB1, CB2

Question 13

MAIN difference between the 2 cannabinoid receptors?

Answer 13

distrubution:
CB1: throughout the body
most abundant in brain
CB2: in peripheral organs with immune functions

Question 14

roles of CB1 in the brain

Answer 14

motor function, cognition, memory, appetite, pain

Question 15

how does cannabinoid signaling differ from normal neuronal signalling

Answer 15

normal: NT travel from pre to post synapic cleft
cannabinoid: retrogradely; diffuse backwards from post to pre