5.9 Pharmacology Of Cannabis-cannabinoids Flashcards

1
Q

What are the key components of cannabis sativa/indica?

A
  • Delta9-tetrahydrocannabinol
  • Cannabidiol
  • Cannabinol
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2
Q

How much THC is in hemp?

A

0.3% or less

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3
Q

What is industry hemp?

A

Strain of cannabis that is grown for agricultural products such as textiles, seeds, and oils

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4
Q

How much THC does marijuana contain?

A

15-20% of THC

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5
Q

What is the classification of cannabis under the federal controlled substance act?

A

Cannabis remains schedule 1

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6
Q

What did Obama do in 2014 regarding legalization of hemp?

A

Obama signs Farm Bill, allowing hemp to be cultivated for research purposes

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7
Q

What happened in 2018 regarding legalization of hemp?

A

Farm Bill of 2018 passes, federally legalizing hemp and hemp-derived products, including CBD oil

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8
Q

What is the structure of Delta8-THC?

A
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9
Q

How is tetrahydrocannabinolic acid (THCA) converted to delta9-THC?

A
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10
Q

What are perceptual SEs of acute cannabis intoxication?

A
  • Temporal slowing
  • Auditory, visual, or tactile illusions
  • De-personalization
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11
Q

What are affective SEs of acute cannabis intoxication?

A
  • Euphoria
  • Disinhibition
  • Anxiety
  • Emotional lability
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12
Q

What are physical SEs of acute cannabis intoxication?

A
  • Tachycardia
  • Postural hypotension
  • Conjunctival injection
  • Dry mouth
  • Increase appetite
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13
Q

What are cognitive SEs of acute cannabis intoxication?

A
  • Suspiciousness or paranoid ideation
  • Impaired judgement
  • Impaired rxn time
  • Impaired attention
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14
Q

What is the endocannabinoid system (ECS) comprised of?

A
  • Receptors (CB1 and CB2)
  • Ligands (anadamide [AEA] and 2-AG)
  • EMT, endocannabinoid membrane transporter
  • Fatty acid amide hydrolase, FAAH; mono-glycerol lipase, MAGL, diacyl glycerol lipase, DAG
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15
Q

What do endocannabinoid and phtyocannabinoids serve as?

A

Serve as retrograde regulators of neurotransmission, inhibiting release of GABA and glutamine

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16
Q

What is THC and synethic cannabinoids?

A
  • THC is a partial agonist at CB1R
  • Synthetic cannabinoids are full agonists
17
Q

Which CB receptor is higher in the brain?

A
  • CB1 expression in brain is higher than CB2 receptor expression
  • Low levels of respiratory centers of brainstem (<resp depression, coma)
  • CB2 on glia
18
Q

Which CB receptor expression is higher in the periphery?

A
  • CB2 receptor expression&raquo_space; CB1 receptor
  • CB2 on lymphocytes (B and T cells)
  • CB1 on liver (increase lipogenesis)
  • Upregulated in liver fibrosis
19
Q

What is Marinol (dronabinol)?

A
  • FDA approved synthetic d9-THC in sesame oil
  • Schedule 3
  • Counter loss of appetite
  • Tachycardia, red eyes
20
Q

What is nabilone (cesamet)?

A
  • FDA approved THC mimetic
  • Schedule 3
  • Anti-emetic
  • Chronic pain (off pain) for fibromyalgia, MS
21
Q

What are challenges w medical marijuana use?

A
  • Lack of product quality control
  • Absence of adequately designed studies for assessing efficacy and ADR
  • Highly politicized environment precludes a rational approach
  • Growing influence of big tobacco and alcohol industries in cannabis industry
22
Q

What is the pharmacological profile of cannabidiol (CBD)?

A
  • Low affinity for CB receptors
  • May antagonize THC @ CB1
  • Promiscuous effects on ECS
  • Lacks euphoric effects
23
Q

What is cannabidiol (CBD) FDA approved for?

A

FDA approved drug for rare seizure disorders:
- Dravet syndrome
- Lennox-Gastaut syndrome

24
Q

What is the criteria for cannabis use disorder?

A

> = 2 criteria

25
Q

Is cannabis use associated with mental health disorders?

A
  • Extremely difficult to prove and controversial
  • Growing evidence for association w several disorders, cause and effect not established
26
Q

What are risk factors and pathway to psychosis?

A

Age of use onset and potency appear to be key determinants

27
Q

What are diagnostic criteria for cannabinoid hyperemesis syndrome?

A
  • Cyclic vomiting/abdominal pain
  • Presentation after prolonged, excessive use
  • Relief by sustained cessation
  • May be associated with pathological bathing (hot showers/baths)
28
Q

What are the txs of cannabinoid hyperemesis syndrome?

A
  • Cannabis cessation
  • Benzos
  • Haloperidol
  • Capsaicin cream (abdomen)
29
Q

What is the mechanism of capsaicin for cannabinoid hyperemesis syndrome?

A
  1. Substance P activates neurokinin-1 receptors in medullary vomiting center of CNS causing N/V
  2. Activation of transient receptor potential vanilloid-1 receptor by heat, capsaicin, or acidic conditions causes depletion of substance P
  3. Chronic cannabis use causes desensitization and downregulation of TRPV-1 receptors
  4. Topical capsaicin applied to abdominal area provides multiple mechanisms of symptom relief