Tobacco, Vaping, Marijuana And CBD

Question 1

What is vaping?

Answer 1

The act of inhaling and exhaling an aerosol or vapor made from a liquid or dry material that is heated in an electronic powered device called an electronic cigarette

Question 2

What are some of the benefits of vaping?

Answer 2

Less expensive, tastes better, fingers no longer stink and stains slowly disappear, teeth get whiter, overall looks improve, sense of smell and taste imrpove, social interactions increase, dont need to go outside for a smoke break, causes less damage to the lungs, can help ppl stop smoking cigarettes

Question 3

Is vaping safe?

Answer 3

Not considered safe for teens and YA esp since the adolescent brain is still developing and taking in these substances may be harmful; also some vape devices may explode resulting in burns and other injuries

Question 4

Is it true that vapes only contain water vapor?

Answer 4

No, most contain and release a number of potentially toxic substances including metals and volatile organic compounds, some of which have been linked to cell and DNA damage

Question 5

Can vaping help you quit smoking?

Answer 5

Although using e-cigarettes as a way to stop smoking may work for adults, teens and YA who vape are almsot 4x as likley to begin smoking traditional cigarettes as those who dont smoke

Question 6

What is the function of the prefrontal cortex?

Answer 6

Drives executive function which includes differentiating between conflicting thoughts, recognizing good vs bad, anticipating consequences/outcomes based on current actions, activies and urges, motivation needed to work toward a defined goal

Question 7

Why are adolescents more vulnerable to initiation to drugs and subsequent addiction?

Answer 7

Age of increased risk taking, impulsivity and novelty seeking behavior due to incomplete development of the prefrontal cortex

Question 8

Nicotine has not been associated with what?

Answer 8

Liver test abnormalities or with clincally apparent hepatotoxicity

Question 9

What is the fatal adult dose of nicotine?

Answer 9

60mg

Question 10

How does nicotine interfere with maturation of the prefrontal cortex?

Answer 10

Neuroplasticity is impaired which leads to alterations in gene expression, cell structure, intracellular signaling, synaptic pruning (removing redundant connections) and axon myelination

Question 11

What are the effects of nicotine on the adolescent prefrontal cortex?

Answer 11

Causes long term cognitive impairment affecting both accuracy and impulse control, decreased memory and attention, behavioral disturbances later in life such as SUD and mental health problems

Question 12

What are the physiological affects of marijuana?

Answer 12

Altered sense (ex. Seeing brighter colors), altered sense of time, changes in mood, impaired body movement, difficulty with thinking and problem solving, impaired memory, hallucinations, delusions and psychosis (when taken in high doses)

Question 13

What is the psycho-active compound of marijuana?

Answer 13

THC (delta 8 and 9)

Question 14

Where is the CB1 receptor expressed and what are its effects?

Answer 14

Expressed in the CNS and has psychoactive effects

Question 15

Where is the CB2 receptor expressed?

Answer 15

Expressed in the immune system and hematopoietic cells

Question 16

What is the active but not psychoactive component of cannabinoids?

Answer 16

Cannabidiol

Question 17

What factors play a role in testing for marijuana use?

Answer 17

Your individual metabolism, how often marijuana is consumed, BMI (the higher the longer it takes), how strong is the consumed marijuana, how much is consumed, which drug test is done

Question 18

How can you pass a drug test naturally?

Answer 18

Drink lots of water, get some exercise, eat green leafy vegetables, drink lemon juice, skip eating junk food and red meat, opt to drink tea, eat lots of food with healthy fiber, abstain and test yourself

Question 19

What is dronabinol?

Answer 19

Orally administered synthetic delta-9 THC —> analgesia, appetite enhancement, muscle relaxation and hormonal actions mediated by CB1 receptors with peak effects in 2-4 hours

Question 20

What are the psychological effects of dronabinol?

Answer 20

Affective (euphoria, easy laughter), sensory (increased perception of external stimuli, own body), somatic (feeling of body floating or sinking in bed), cognitive (altered time perception, memory lapses, etc)

Question 21

What are the indications for dronabinol?

Answer 21

Anorexia in AIDS pts, chemotherapy-induced N/V; off label use for moderate to severe OSA

Question 22

What is nabilone?

Answer 22

THC capsule approved for chemotherapy induced N/V

Question 23

What are the adverse effects of marijuana?

Answer 23

Affects judgement and coordination thereby increasing risk for accidents, sedation, bloodshot eyes, depression, dizziness, tachycardia, hypotension, hallucinations, dry mouth

Question 24

What are some conditions with evidence of cannabis efficacy?

Answer 24

Chronic pain (esp for neuropathic pain), N/V, stimulating appepite during cancer or HIV anorexia and cachexia, MS (helpful for spasiticty, associated pain and bladder function), anxiety (and maybe PTSD); some/limited evidence for sleep quality and tourette’s syndrome

Question 25

For which conditions is there a lack of efficacy for cannabis?

Answer 25

Acute pain, tremor in MS, Huntington’s dz, glaucoma (other drugs are better), schizophrenia, depression, and slowing cancer cell growth

Question 26

What is the oral bioavailability of CBD?

Answer 26

6% due to significant first pass metabolism; has poor aqueous solubility -> to erratic absorption from GI tract; aerosolized inhaled CBD has higher bioavailability

Question 27

Where does CBD accumulate in the body?

Answer 27

Rapidly distributes and has a high volume of distribution but accumulates in adipose tissue

Question 28

CBD is extensively metabolized by what?

Answer 28

In the liver by 7 CYPs primarily CYP3A4 and CYP2C19

Question 29

What are some therapeutic applications for CBD?

Answer 29

Alzheimer dz, N/V, fragile X syndrome, skin diseases, CBD tampons for menstrual pain, anxiety/depression

Question 30

What are the adverse reactions of CBD in humans?

Answer 30

No cardiovascular effects and generally well tolerated; increased drowsiness, fatigue, decreased appetite, diarrhea, anemia, infections, etc have been seen (with Epidiolex); dont produce psychoactive effects, no potential for abuse, no tolerance or withdrawal

Question 31

What is epidiolex?

Answer 31

An oral CBD solution approved by the FDA as a schedule V drug for tx of rare childhood epilepsies in people 2 years of age or older (Lennox-Gastuat syndrome and Dravet syndrome)

Question 32

What is the toxicology for CBD?

Answer 32

No effect on embryonic development, no effect on a wide range of physiological and biochemical parameters, no evidence of abuse potential or dependence, effects on immune system are unclear, some potential for drug drug interactions through inhibiton of some CYP450 enzymes

Question 33

What should be monitored when taking Epidiolex?

Answer 33

Look for evidence of liver toxicity and suicidal ideation