Synthetic Cannabinoids OD Flashcards
Cannabinoids MoA
Bind and agonize the cannabinoid receptors
Origin of phytocannabinoids
Plant-based
Which part of the plant has more THC: hemp or MJ
MJ (the little fuzzy parts of the plant)
Wanted effects of phytocannabinoids
Mood elevation, euphoria, relaxation, creative thinking, increased sensory awareness, appetite stimulation, nausea suppression
Paradoxical effects of phytocannabinoids
Short-term memory difficulties, agitation, feeling tense, anxiety, dizziness, lightheadedness, confusion, loss of coordination
How do you make a synthetic cannabinoid?
Mix and match a rink, link, core, and tail to form different combos
THC is a _________ a CB1 receptors.
partial agonist
THC effects
Mood elevation, euphoria, relaxation, creative thinking, increased sensory awareness
Desired effects of synthetic cannabinoids
The same effects as THC
Unwanted effects of synthetic cannabinoids
Pretty much anything else…
tachy/bradycardia, agitation/irritability, N/V, drowsiness, confusion, seizures, ischemic stroke, MI, cardiac arrest, tremors, hallucinations, respiratory depression, rhabdomyolysis….the list goes on but it’s not good
Where are CB1 receptors expressed?
Brain regions
Where are CB1 receptors not found and what does it explain?
The brainstem, which explains the lack of coma and respiratory depression seen
Where are CB2 receptors expressed?
Periphery in immune cells
Signs and symptoms of synthetic cannabinoid OD
CNS depression, disorientation, restlessness/agitation, hallucinations, generalized seizures, combativeness, anxiety, mydriasis, tachycardia, vomiting
Lab abnormalities of synthetic cannabinoid OD
Decreased potassium
Increased BG, CK, WBCs, creatinine
Supportive care for synthetic cannabinoid OD
Fluids/electrolyte management
Antiemetics
BZDs
Ketamine if the patient is profoundly agitated and aggressive
Intubation
Patho of cannabinoid hyperemesis syndrome: what is dysregulated?
The endocannabinoid system
Patho of cannabinoid hyperemesis syndrome: what happens as a result of endocannabinoid dysregulation?
Desensitization and downregulation of CB1 receptors that generally has antiemetic effects
Patho of cannabinoid hyperemesis syndrome: what is altered
The TRPV1 receptor after chronic cannabinoid use
Diagnosis of cannabinoid hyperemesis syndrome
Hx of regular cannabis use
Cyclic N/V
Generalized, diffuse, abdominal pain
Compulsive hot showers with symptom management
Phases of CHS: pre-emetic/prodromal phase- how long is it?
Months-years
Symptoms of pre-emetic/prodromal phase of CHS
Diffuse abdominal discomfort, feelings of agitation or stress, morning nausea, and fear of vomiting → increased use of MJ to treat
Phases of CHS: hyperemetic phase- how long is it?
24-48 hours
Symptoms of hyperemic phase of CHS
Cyclic episodes of N/V
Diffuse, severe abdominal pain
