MMJ Flashcards
Preferred Term for Medical Marijuana
Medical Cannabis
What is the main psychoactive ingredient in marijuana?
THC
Delta-9-tetracannabinoid
What is the active ingredient in Marinol and Syndros?
Dronabinol
-Synthetic THC
What is the active ingredient in Cesamet?
Nabilone
-Synthetic agent similar to THC
What is the active ingredient in Epidiolex?
Cannabidiol
What does Epidiolex treat?
Lennox-Gastaut and Dravet syndromes
-Epileptic disorders
Responsibility of Endocannabinoid System (ECS)
- Maintain homeostasis
- Naturally produces endocannabinoids
- Modulates ECS
Where are CB1 receptors found?
CB1: Central and peripheral NS
Where are CB2 receptors founds?
CB2: Immune, blood, and PNS
CBD: Cannabidiol uses
Promising small trials: Anxiety, SUD, Parkinson’s, schizophrenia
Others: AD, MS, Huntington’s, hypoxia-ischemic injury, CVD, migraines, depression, cancer, nausea, inflammatory diseases, RS
CBD routes of adminitration
Edible oil
Vapes
Topical lotions/oils
Rectal/Vaginal suppositories
Adverse effects of CBD
fatigue, elevated LFTs, anemia, infections (pneumonia), diarrhea
Somnolence, sedation, lethargy, decreased appetite
CBD urine/blood toxicology
Will screen positive for marijuana with drug screen - need GC/MS testing to distinguish between CBD and THC
CBD and CYP2C9 Interaction
Ex: warfarin
Inhibits CYP2C9 enzyme
Increased INR and r/f bleeding
CBD and P-glycoprotein (P-gp) interaction
Eg: Direct oral anticoagulants (DOACs)-dabigatran, apixaban, rivaroxaban, clopidogrel
DOACs are substrates of P-gp
CBD may inhibit P-gp, increasing DOACs concentration/accumulation, increasing r/f bleeding