Medical Marijuana Flashcards

1
Q

Where are most CB1 receptors located?

A
  1. Brain (mostly in CNS)
  2. Adipocytes
  3. Hepatocytes
  4. Musculoskeletal tissues
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2
Q

Where are most CB2 receptors located?

A

Peripheral organs especially cells associated with the immune system

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3
Q

What effect does THC have on CB receptors?

A

Psychoactive effects
1. Primarily binds to CB1 receptors
2. Partial agonist at CB1 and CB2 receptors

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4
Q

What effects does CBD have on CB receptors?

A

Anti-psychoactive that controls high
1. Partial agonist or CB2 receptors and non-cannabinoid receptors

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5
Q

What are terpenes?

A

Influence the aroma and effect of specific cultivars for different medical conditions

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6
Q

How is cannabis distributed?

A

90% protein bound, 10% unbound and can bind to CB1 receptors

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7
Q

How is cannabis eliminated?

A

30% in urine
70% in feces

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8
Q

What is the metabolism of cannabis?

A

CYP2C9 (major)
CYP3A4 (major)

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9
Q

What is the active metabolite of delta 9 THC?

A

11-OH-THC

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10
Q

What is a typical dose on THC?

A

2.5-10mg

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11
Q

What delivery systems are there for THC?

A
  1. Smoking/vapor
  2. SL, buccal
  3. Topical
  4. Rectal/vaginal
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12
Q

What are short-term SEs of THC?

A
  1. Coughing, dry mouth/throat
  2. Red, irritated eyes
  3. Dizziness
  4. Tachycardia, hypotension, palpitations
  5. Confusion, anxiety
  6. Nausea
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13
Q

What are long-term SEs with THC?

A
  1. Bronchitis in long-term smokers
  2. Cognitive defects with heavy, longterm consumption
  3. Cannabis hyperemesis syndrome
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14
Q

What disease states is THC a concern in?

A
  1. Schizophrenia,bipolar, severe depression
  2. Heart disease, HTN
  3. ANGINA, ARRHYTHMIAS, hx of stroke
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15
Q

What are symptoms of THC dependence?

A
  1. Excessive, daily use of cannabis
  2. Tolerance that requires increased dosing to achieve effects
  3. compulsion to use cannabis whenever available/ offered
  4. use results in failure to fulfill obligations
  5. activities given up or reduced because of cannabis use
  6. use in hazardous situations
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16
Q

What drugs does cannabis potentiate the effects of?

A
  1. alcohol
  2. benzodiazepines
  3. opioids
17
Q

What are drug interactions with cannabis?

A
  1. inhibit P-glycoproteins efflux pumps
  2. effect drugs with narrow therapeutic index (warfarin, phenytoin, dabigatran, digoxin, and tacrolimus)
18
Q

What medications increase the effects of cannabis?

A
  1. Clarithromycin/Erythromycin
  2. Fluconazole, Itraconazole, Ketoconazole
  3. verapimil, diltiazem, amiodarone
  4. Ritonavir, Atazanavir
19
Q

What medications decrease the effects of cannabis?

A
  1. phenobarbital, phenytoin, carbamazepine
  2. Rifampin, rifabutin
  3. st johns wart
  4. Ritonavir
20
Q

What medications do cannabinoids increase clearance of?

A
  1. Olanzapine
  2. Theophylline
21
Q

What is the onset of inhaled cannabis?

A

peak:5-10 min

22
Q

What is the onset and peak of buccal cannabis?

A

onset: 5-15 min
peak: 45 min-2h

23
Q

What is the onset and peak of oral cannabis?

A

onset: 30min-2h
peak: 2-7 h

24
Q

What is the FDA approved indication for Cannabidol (EPIDIOLEX)?

A

to treat seizures associated with Lennox-Gastaut syndrome, Dravet syndrome, or tuberous sclerosis complex in patients 1 year and older

25
Q

What are SEs with Cannabidol?

A
  1. somnolence
  2. decreased apetite
  3. diarrhea
  4. fatigue
  5. malaise
  6. rash
26
Q

What is the FDA approved indication for dronabinol (MARINOL, SYNDROS)?

A

anorexia in patients with AIDs, CINV, and moderate-severe obstructive sleep apnea

27
Q

What is the difference between MARINOL and SYNDROS?

A

syndros- schedule 2
marinol- schedule 3

28
Q

What are SEs with dronabinol?

A
  1. euphoria/antiemetic
  2. appetite stimulant
  3. hypotension
  4. cannabinoid hyperemesis syndrome