MJ and Vaping - Block 3 Flashcards
Nicotine ADR?
Adolescence: addication and harm to developing brain
Pregancy: SID
Ingestion of ecg: acute tox and death
Ecig: exposure to heavy metals, arsenic, volatile organic compounds
MJ plant characterisitcs?
- An annual, dioecious, flowering herb
- Wind pollinated and produces seeds insode tny fruits
What are common uses of MJ?
Seeds: food and hemp seed oil
Stalks: fiber
Resin: drugs
Describe the site of action of cannabinoid?
Differntiate the 2 subtypes of cannabinouds?
THC: docks at the brains cannabinoid receptor -> psychoactivity is inebriation or high
CBD: psychoactivity is sedation and anxiolytic without inebriation
What is the most commonly used illicit drug?
MJ
What is hashish?
Compressed resin of cannabis plant and more concentrated/potent
What is hash oil?
Psychoactive chemicals extracted from cannabis plant with butane or potent than plant
Describe the different routes of MJ use?
Smoking: quick onset, allows patient to regulate dosing by titrating inhalation
Vaporizing: quick onset like smoking, delivery delay, risk of overmedication
Edibles/oral: slow onset of action, active metabolite, greater duration of action, overmedication, higher risk of child poisoning
Topical: benefit in dermatologic inflammatory conditions
Rectal
Sublingual
Why do people recreationally use MJ?
- To get high (fun, new experience)
- To fit in
- To socialize
- To cope with physical/emotional discomfort
- Euphoria, relaxation, changes in perception
- Sense of well being
- Enhance seses
- Sociality
What are acute effects of use?
- Intoxication
- Euphoria, relaxation/sedation, change in pain sensation, distortion of sensory perception, thought and time distortion
- Increased HR, and decreased BP
- Blood shot eyes
- Memory impairment
What are the psychological effects of higher doses of MJ?
- Visual distrotion
- Sense of time altered
- Attention span and memory affects
- Though processing
- Mental perception
What are the risks of use?
- Lung and throat problems
- Carcinogenic effects
- Decreased eye pressure
- Allergies
- Heart issues: MI and stroke risks
- Risk of developing schizo
Smoke is associated with ___?
- Cancer
- Lung damage
- Poor pregnancy
Patient who regularly use MJ can develop ___?
Dependence
Most common drugs that have dependence risk?
- Nicotine
- Heroin
- Cocaine
- Alcohol
- MJ
DSMV MUD criteria?
Use for 1 yr and at least 2 of the following:
1. Larger amounts used
2. Failed effort to discontinue
3. Inordinate amount of time is occupied acquiring MJ
4. Cravings
5. Continued use of cannabis despite adverse consequences
6. Drug use supersedes activities
7. Tolerance
8. Withdrawal
9. Use of cannabis continues despite awareness of physical or psychological problems
What are the active ingredients for medical MJ?
- CBD
- THC
- Terpines
Health risk with med mj?
- TOlerance develops
- Potential for dependence
- Withdrawal sx occur but mild
Positive evidence of Med Mj use?
- Appetite stimulant in wasting syndromes
- Analgesic and antispasmodic
- N/V
- Hep C
MJ for AIDS wasting and chemo?
Ax reduction, appetite stimulation, n reduction, pain relief
Marginal evidence of MJ?
Glaucoma, bronchodilator
What are the approved MJ products?
Dronabinol (Marinol): synthetic THC
Nabilone (Cesamet): Synthetic THC
CBD (Epidiolex)
ADR of med MJ?
- Drowsiness, dz, irritability, coordination and memory impairment
- Dronabinol – restlessness, drowsinessanddizziness
What is CBD?
Potent antioxidant and anti-inflammatory
Indication for Medical CBD?
- Child epilepsy
- Dravet and Lennox-Gastaut syndromes
- sleep disorder
ADR of CBD?
- Bloodshot eyes
- Increased appetite
- Lack of motivation
- Weight gain
- Nervous or paranoid behavior
- Impaired coordination
- Slowed reaction time
- Cannabinoid Hyperemesis Syndrome
- Dry mouth
- Memory impairment
- Anxiety
- Impaired judgment
- Distorted perception
- Relaxed state/sleepiness
- Feeling “high” or euphoric
Resp ADR?
Bronchitis
CV ADR?
Tachycardia, HTN, angina
CNS ADR?
Sedation, reduced perception, pschomotor function
Psychiatric ADR?
Psychosis, bipolar, SUD
Repro ADR?
Decreased fetal growth, preterm birth
Physical dependence ADR?
withdrawal symptoms include anxiety, restlessness, depression, irritability
Patient populations that are cautioned against MJ use?
- Uncontrolled HTN
- Schizo, bipolar, depression
- Hx of stroke
- Elderly
- Pregnancy and lactation
- Pediatric
- Liver or kidney dx
DDI associated with MJ?
THC and CBD is metabolized by CYP2C9 (poor metabolizer -> increased levels) and 3A4
CYP2C9 inhibitors may increase THC/CBD levels (amiodarone, clopidogrel, fluoxetine, metronidazole etc. )
CYP34A inhibitors may increase THC/CBD levels (ketoconazole, clarithromycin, verapamil etc.)
CYP2C9 inducers that may decrease THC/CBD levels (barbiturates, carbamazepine, phenytoin, rifampin etc.)
CBD is a potent inhibitor of CYP3A4 and 2D6
THC is a CYP1A2 inducer
Outcomes of MJ drug screening?
- Postive for up to 3-90 days
- CBD will nor test positive for THC, however, most CBD contains some THC
Uses for medical MJ?
- Pain relief
- Sleep
- Relax
- Muscle spasm
- Ax
- Stimulate appetite
- Nausea
- Depression
INdication that might require MJ?
- Chronic pain
- Mental health dx
- Sleep dx
- Neurological dx
- HIV
- Cancer
- Glaucoma
Describe the MS medical Cannabis Act?
- qualifying patient- have at least one qualifying medical condition written by MD (Application for registration card in $25)
- Certified practitioners-have completed eight hours of continuing medical education courses on medical cannabis, plus five hours every year thereafter.
- Potency cap - lower can’t exceed 30% THC (Tinctures, oils, concetrates may not exceed 60%)
- Possession and purchaselimits
What does the bill not do?
- Doesn’t require insurance or state plas to cover medical cannabis
- Doesnotrequire any employer to allow patients to use medical cannabis or prevent them from requiring drug testing.
Medical conditions the can participate in Mississippi Medical Cannabis Program?
- Cancer
- PD
- Huntington
- muscular dystrophy
- GLaucome
- Spastic quadriplegia
- Positive status for HIV
- AIDS
- Hepatitis
- ALS
- CD
- UC
- sickle cell
- AD
- Agitation of dementia
- PTSD
- autism
- Pain refractory
- Neuropaty
- Spinal cord injury
Qualifying is a chronic terminal or debilitating disease or medical condition or its treatment that produces one or more of the following:
- Cachexia, wasting syndrom
- Chronic pain
- Severe/intractable N
- Sz
- Severe and persistant muscle spasms
MS pharamcist role in MJ use?
- No requirement for any involvement of a licensed pharmacist
- Dispensary staff and dispensing practitioners must complete at least eight hours of continuing education on medical cannabis, plus five additional hours every year
- Dispensary must report dispensing information every 24 hours (patient ID and amount dispensed)
