Tobacco, Vaping, Marijuana, CBD - Wolff Flashcards
what is the brain region that drives executive function?
prefrontal cortex
how does nicotine interfere with maturation of the prefrontal cortex?
it impairs neuroplasticity (the ability of the brain to change continuously throughout a person’s life)
leads to alterations in:
- gene expression
- cell structure
- intracellular signaling
- synaptic pruning (removing redundant connections)
- axon myelination
nicotine administration in adolescent rats causes what?
long-term cognitive impairment
brain function studies of adolescent smokers shows decreased activity in what part of the brain?
prefrontal cortex, including decreased memory and attention
what patterns of illness have been linked to vaping?
heterogeneous collection of pneumonitis:
- acute eosinophilic pneumonia
- organizing pneumonia
- lipoid pneumonia
- ARDS
- diffuse alveolar hemorrhage
- hypersensitivity pneumonitis
what is the danger with aerosolizing oils?
it allows them to penetrate deep in to the lungs and coat the surfaces, creating a thin layer of oil that extracts/accumulates toxins and particles from inspired air based on their oil-water partition
what are the two main chemicals in marijuana?
- 9-tetrahydrocannabinol (THC)
- cannabidiol (CBD)
endocannabinoids are produced on demand in post-synaptic neurons by stimuli that result in what?
elevations of intracellular Ca2+ levels -> activation of diacylglycerol lipase (DAG-lipase)
synthesized endocannabinoids then diffuse into the synaptic space, travel in a retrograde manner, and bind to what?
- *CB1 receptors** on presynaptic neurons
- anandamine (partial agonist)
- 2-arachidonoylglycerol (2-AG, full agonist)
what are the enzymes that hydrolyze endocannabinoids?
- FAAH found in principally in POSTsynaptic cells breaks down anandamine
- MAG-lipase breaks down 2-AG in PREsynaptic cells
what is synthetic THC called?
dronabinol
analgesia, appetite enhancement, muscle relaxation and hormonal actions are mediated by which cannabinoid receptors?
CB1
what are the 4 categories that psychologic effects are divided into?
- affective: euphoria, easy laughter
- sensory: increased perception of external stimuli
- somatic: feeling of body floating of sinking in bed
- cognitive: altered time perception, memory lapses
what are the labeled indications for dronabinol?
anorexia in AIDS patients, chemotherapy-induced nausea and vomiting
what is the name of the THC capsule approved for chemotherapy induced nausea and vomiting?
nabilone
what are the conditions for which cannabis lacks efficacy?
- acute pain
- tremor in MS
- Huntington’s disease
- glaucoma
- schizophrenia
- depression
- slowing cancer cell growth
what are the contraindications for cannabis?
- hx of psychosis
- current or past substance
- CV or respiratory disease
what are the cautions for cannabis?
- age <25
- active mood disorders
- risk factors for CV disease
- ongoing use of high doses of alcohol or benzodiazepines
this naturally occuring (-) enantiomer is generally administered orally, but has poor aqueous solubility and a significant first pass metabolism (extensively metabolized by 7 CYP’s)
CBD
- like THC, it rapidly distributes, has high volume of distribution, and accumulates in adipose tissue d/t high lipophilicity
- generally well tolerated
- does not produce phychoactive effects that are typically seen with THC
- has not been shown to have potential for abuse
- tolerance and withdrawal have not been reported
CBD
- no effect on embryonic development
- no effect on a wide range of physiological and biochemical parameters
- some potential for association with drug interactions
CBD
what two syndromes/studies have shown BCD to be useful?
- Dravet syndrome (childhood myoclonic seizures, triggered by warm baths)
- Lennox-Gastaut syndrome (childhood onset, daily tonic seizures during non-REM sleep)
what are the other therapeutic CBD applications?
- Alzheimer disease
- nausea and vomiting
- pain
- Fragile X syndrome
- skin diseases
- cancer
- CBD tampons
- ADHD
- anxiety/depression
- schizophrenia
