Lecture 3 - Cannabis, salvia and nitrous

Question 1

What is the psychoactive component of cannabis (the plant:cannabis sativa) and what is it composed of?

Answer 1

tetrahydrocannabinol and it is composed of 5 carbon alkyl chain, a pyran, phenol ring and a mono unsaturated cyclohexyl ring.

Question 2

What is the mechanism of action of tetrahydrocannabinol?

Answer 2

Tetrahydrocannabinol acts on CB1R found in the CNS and CB2R found in peripheral. This leads to an increase in GABA and dopamine. The clinical uses of cannabis is pain management, anti emetic, appetite stimulant and anti spastic.

Question 3

What consequences do cannabis abuser experiences?

Answer 3

They experience social, psychological and physical consequences. Examples are financial difficulties, low energy, sleep problems, memory problem, low self esteem, fall in productivity, low life satisfaction.

Question 4

What are the common forms of abused cannabis?

Answer 4

1. Dried flowering tops of female plant
2. Resin and oils
3. Some advocate of juicing the fresh plant.

Question 5

What are the route of administration used in illicit use of cannabis?

Answer 5

1. Inhalation with or without tobacco or water pipes.
2. Orally, food supplement or mixed with food. It is metabolised in the 11-OH-THC to produce longer lasting and more potent effects.

Question 6

What are the formulations available that are licensed.

Answer 6

1. sublingual aerosol

2. THC capsules

Question 7

List the therapeutic uses of cannabis.

Answer 7

1. Neurapathic pain
2. MS related spasticity
3. Appetite stimulation in AIDs stimulation
4. Chemotherapy related nausea

Question 8

What is salvinorin A?

Answer 8

Salvinorin A is an active constituent of the plant Salvia Divinorum which is hallucinogenic.
Salvinorin A is metabolised to Salvinorin B which is a selective and potent kappa-opioid receptor agonist.
The effects are visual hallucinations, modified state of awareness.

Question 9

List the effect of nitrous oxide on the CNS and the mechanism of action

Answer 9

Nitrous oxide has analgesic, euphoric and anxiolytic affects. It enhances endorphin release which induce analgesia through opioid receptor activation. It also induces dopamine release which causes the euphoric effect. The anxolytic effect is due to GABA mediation.

Question 10

What are the effects of abusing nitrous oxide.

Answer 10

Dizziness
Euphoria
Sexual perfomance enhancer
Burst of laugh
Dissociation

Question 11

What are the mechanism of high level inhalation toxicity of nitrous oxide?

Answer 11

Nitrous oxide make vit B12 unavailable and this leads to over stimulation of NMDA receptor hyperacidification and apoptosis. The physical symptoms include nerve damage, demyelination and neuropathy. It can cause nausea and vomiting.
Only way to reverse effects is with high doses vit b12.