Medical cannabis Flashcards by Yaz Bassi

In Interior Health (IH), what does the Cannabis for Medical Purposes Policy state?

 With a prescription, clients in IH facilities may smoke medical cannabis in designated locations (e.g.
outdoor cafeteria seating)
 Registered nurses may administer prescribed medical cannabis to clients with a valid doctor’s order
 Nurses must document the use of medical cannabis (including date, time, amount, dosage form) in
the client’s health record
 The facility’s pharmacy is responsible for procuring and supplying medical cannabis to clients with a
valid doctor’s order

 Nurses must document the use of medical cannabis (including date, time, amount, dosage form) in
the client’s health record

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Can individuals smoke on IH property

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Which client would be the most appropriate to receive a prescription for medical cannabis?

 23-year old male client with a history of acute leukemia
 28-year old pregnant client with a history of multiple sclerosis
 45-year old male client with diabetic peripheral neuropathy
 55-year old female client with a history of chronic stable angina

 45-year old male client with diabetic peripheral neuropathy

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If a patient wants to use whole flower (bud) or ground up (milled) cannabis, what should the nurse reccomend following harm reduction protocols

to vaporize it

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What statement is true about the pharmacokinetics and pharmacodynamics of ORAL cannabis?

 Drug effects or oral cannabis peak in 5-10 minutes
 Oral cannabis has a duration of action of 6-8 hours
 Bioavailability of oral cannabis is decreased when taken with a fatty meal
 When taken orally, most cannabis metabolism occurs in the kidneys

 Oral cannabis has a duration of action of 6-8 hours

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Are cannabinoids fat-soluble or water soluble

fat soluble

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Where does cannabis metabolism occur

liver

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what happens to absorption and bioavailabilty of cannabis when taken with fatty foods

enhanced

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What needs to be obtained for a clients chart if they are to be authorized to use medical cannabis

The medical document signed by a family physician,
authorizing cannabis for medical purposes,
A client-specific supply label or shipping document, from the Licensed Producer that supplies the cannabis

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Can nurses in IH administer medical cannabis

Nope

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What is the maximum amount of medical cannabis that a client may possess at any time?

 5 grams
 5 day supply
 150 grams
 There is no maximum limit now that cannabis is legal

150 grams or a 30 day supply

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what cardiovascular effects can be caused by use of cannabis

sudden drop in BP

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On a perscription bottle of cannabis, what number indicated THC and what number indicates CBD

the first number is THC and second is CBD

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What is an example of a serious “red flag” drug interaction with cannabis?

 Cannabis inhibits the metabolism of warfarin, causing increased INR and increased risk of bleeding
 Cannabis speeds up metabolism of benzodiazepines like lorazepam and reduces their effects
 Cannabis increases serum concentration of acetaminophen and increases the risk for toxicity and liverdamage
 Cannabis increases clearance of ramipril and reduces its effectiveness which may elevate blood
pressure

 Cannabis inhibits the metabolism of warfarin, causing increased INR and increased risk of bleeding

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What effect does cannabis have with benzos such as lorazepam

additive

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What are endocannabinoids

naturally produced in the body and form part of the endocannabinoid system

what are phytocannabinoids –

found in many plants, but in the highest concentration in the cannabis plant

what are synthetic cannabinoids

– which are chemicals produced in a laboratory that have the same, or a similar structure to THC, CBD, and other related cannabinoids.

What are the cannabinoid receptors that humans have

CB1 and CB2

What compounds bind to cannabinoid receptors

(Anandamide) AEA and 2-AG

Where are CB1 receptors primarily found

brain and spinal cord

where are CB2 receptors found

the immune system, GI tract, and PNS

can cannabinoids pass the BBB

yes they can (:

THC effects

Analgesic
Antispasmodic
Anti-inflammatory
Appetite stimulant
Anti-emetic
Psychoactive
properties (e.g.
euphoria)

# ``` ``` CBD effects

*Doesn’t cause euphoria *Inhibits psychoactive side effects of THC (e.g. euphoria, memory loss, anxiety) * Analgesic * Anti-inflammatory * Anti-convulsant * Affects immune function

What prescription medication is synthetic cannabinoid that may be prescribed to treat chemotherapyinduced nausea and vomiting?  Ondansetron  Anandamide  Cannabidiol  Nabilone

 Nabilone

What cannabis product is use for MS to relieve severe muscle spasticity

nabiximols

what is Epidiolex typically used for

difficult to treat forms of childhood onset epilepsy

While reviewing safety measures with cannabis, Delia teaches Rudy about the 4-6-8 rule. What does this rule state?  Avoid driving for 4 hours after inhaling cannabis, 6 hours after ingesting cannabis, and 8 hours if feeling high.  Don’t inhale more than 4 puffs of inhaled cannabis at a time, 6 drops of cannabis oil at a time, or 8 mg of edible cannabis at a time  Inhaled cannabis has a 4-hour half life, ingested cannabis has a 6-hour half life, and topical cannabis has an 8-hour half life  The Cannabis Act permits people to possess a maximum of 4 cannabis cigarettes, 6 grams of dried cannabis, or 8 mL or cannabis oil

 Avoid driving for 4 hours after inhaling cannabis, 6 hours after ingesting cannabis, and 8 hours if feeling high.

If a client is a heavy chronic user of cannabis, how long can metabolites of THC be detected in a urine drug test (UDT)?  1-2 days  4-5 days  7-10 days  Up to 6 weeks

 Up to 6 weeks

How long does it typically take for symptoms of cannabis withdrawal to start?  2-4 hours  6-12 hours  1-2 days  5-7 days

 1-2 days

how many symptoms do people with moderate withdrawal typically have, what about severe withdrawal?

4-5, and 6