Pharmacotherapy

Question 1

anandamide or arachidonylthanolamide

Answer 1

endogenous cabinoid ligaand

Question 2

how does canabis work?

Answer 2

the canibinoid receptor - anandamide inhibits cyclic AMP mediated through G protein coupling in target cells

has role on serotonergic systems (THC reduces serotonin release, also seems to stimulate 5HT synthesis, decrease synaptosomal uptake).

Dopaminiergic system - inhibition of the dopamaniergic system,

Inflammatory mechanisms - inhibit prostaglandin synthsis, and reduce platelet aggregation.

regulates substanc P and enkephalins

and seems to increase eta endorphin (rat model)

Question 3

How does canabinoids affect glutamate

Answer 3

canabinoid receptors through G protein coupling inhibit voltage0gated calcium channels adn activate potassium channels to produce inhibition of glutamate release.

Question 4

Marinol (dronabinol)

List pros/ cons

Answer 4

synthetically derived THC

poor bioavailability and much is filtered with 1st pass

costly

and antecdotally most patient prefer herbal

few reports

some success in migraines.

some effect for spasticity

Question 5

Nabilone

Answer 5

synthetic cannabinoid -pharmaologically similar to THC but more potent, less apt to produce euphoria and lower abuse potential.

-spasticity treatment and MS pain - “scattered reports”

side effects include drowsiness and dysphoria

minimal studies and minimal evidence