[PHARM] Tobacco, Vaping, Medical Marijuana, CBD [Wolff] Flashcards
If you have a 50 patient who is a chronic smoker, and they are un-interested in quitting today, what is a reccomendation you can make for them?
Switching to E-Cigarettes (Juul)
– Less Expensive, Less Damage to Lungs, Contains less in number harmful checmicals, it is addictive (nicotine)
What is the main chemical that is the cause of the Lung Problems from using E-Cigarettes/Juul’s?
Vitamen E Acetate
(Coats the lungs, and can cause extensive lung damage/permanent lung damage)
What causes these patients (espcially patients under 18) to become addicted to Nicotine?
Nicotine affects the Reward Cicruits in the brain
Why are E-Cigarettes potentially harmful to people under the age of 25?
Nicotine can harm the developing brain
Gateway drug?
Addiction
They have incomplete development of the pre-frontal cortex (executive fxn)
Affects Neuroplasticity
Cognitive Impairment/Behavioral disturbances
What are some of the findings of damage to adolescent lungs/mouth from E-Cigarettes?
Vitamin E Acetate (oil)
Can cause a variety of pneumonitis patterns
Explosion of Containers
Teeth Problems/Mouth Dryness
What is the chemical that is responsible for the “High” in Marijuana?
Delta-9-Tetrahydrocannabinol
Marijuana stimulates which receptors?
CB1 >> CB2
What is the normal MOA of the Endocannabinoid system?
Endocannabinoids produced in Post-Synaptic Neurons –>
Elevate Intracellular Ca2+ levels –>
(+) DAG Lipase –>
Endocannabinoids go into synaptic space (travel retrograde) –>
Bind to CB1 receptors on pre-synaptic neurons –>
Bind to Anadamide & 2AG –>
Inhibits Ad Cyclase –>
Causes Hyperpolarization and Less NT release **
How are endocannabinoid actions terminated:
Anandamide?
2-AG?
Anandamide –> broken down by FAAH
2-AG –> broken down by MAG-Lipase
Where are CB2 Receptors primarily found?
On Immune Cells (Modulate Cytokine release)
Is Marijuana legal in all 50 states (Federally)?
Missouri?
No
Yes –> Medically
Need: Written Recommendation, Qualifying Condition, A Medical Card
What are some potential uses of Medical Marijuana?
Good for:
Chronic Pain/Neuropathic Pain
RA, Fibromylagia
N/V
Stimulating Appetite
MS
Anxiety/PTSD
What are some conditions where Marijuana lacks efficacy?
Acute Pain
Tremor in MS
Huntingtons
Glaucoma
Sczhizophrenia
Depression
Slowing Cancer Cell Growth
What are some guidelines to follow when perscribing Medical Marijuana?
Start Low, Go Slow
What are some contraindications/Cautions to Marijuana use?
NO: History of Psychosis
Substance Abuse in past
CV or Resipiratory Dz
Caution: <25
Active Mood Disorders
High Doses of Alcohol or Benzos
