Pharmacology of Cannabis/Cannabinoids

What is the difference between Hemp and Marijuana in terms of THC content?

Hemp is 0.3% or less. Marijuana is 15-20%

What schedule drug is cannabis under the Federal Controlled Substance Act?

Schedule 1

Explain the legalization of Marijuana

Marijuana Tax act in 1937, CA prop 251 which legalized medical marijuana in 1996, Cole Memo act of 2013 which was a hands-off policy

What is hemp and it’s legal THC content

Strain of cannabis grown for agricultural purposes containing 0.3% or less of THC

How much THC is in Marijuana?

15-20%

What are the perceptual effects of cannabis?

Temporal slowing, auditory/visual/tactile illusions, and depersonalization

What are the affective effects of cannabis

Euphoria, disinhibition, anxiety, and emotional lability

What are the conceptual effects of cannabis?

Paranoia, impaired attention, judgement, and reaction time

What are the physical effects of cannabis ingestion?

Tachycardia, postural hypotension, conjunctival injection, dry mouth, and increased appetite

What is the ECS comprised of?

Presynaptic receptors CB1 and CB2. Ligands like anandamide (AEA) and 2-AG. Transporters like EMT. Enzymes like fatty acid amide hydrolase, mono-glycerol lipase, and diacyl glycerol lipase

What is the difference between THC and synthetic cannibinoids

THC are partial agonists of CB1R and synthetic cannabinoids are full agonists

Compare the receptors in Brain vs periphery what does that mean

In the brain, CB1 is expressed more than CB2. There are low levels of respiratory centers in the brainstem which means there are less respiratory depression and coma. In the periphery, there are more CB2 than CB1

List the 3 FDA-approved Cannabinoid Drugs

Marinol/dronabinol, nabilone/cesamet, and cannabidiol/epidolex

What is marinol aka dronabinol and what is it used for

synthetic delta 9 - THC that is used in sesame oil. It is used for AIDs-associated anorexia and refractory chemo-related nausea and vomiting

What is nabilone aka cesamet and what is it used for?

Schedule 2 THC mimetic used for chemo-related nausea and vomiting

What is cannabidiol / epidolex and what is it used for?

FDA approved for CBD indicated for 2 rare seizure disorders: Dravet Syndrome and Lennox-Gastaut Syndrome

Describe the association of cannabis use with mental health disorders

extremely hard to prove but age of use onset and potency appear to be key determinants

What are the diagnostic criteria for cannabinoid hyperemesis syndrome

cyclic vomiting/abdominal pain, presentation after prolonged excessive use, relief by sustained cessation, associated with hot baths or showers

Treatment for cannabinoid hyperemesis snydrome

cessations of cannabis use, BZDs, haloperidol, capsaicin cream on abdomen

What are the moa and effects of endocannabinoids and phytocannabinoids?

They served as retrograde regulators of transmission that inhibit gaba and glutamine

Approximately what percent of cannabis users are estimated to develop cannabis use disorder.

10%

Association of cannabis use and mental disorders is fairly well-established, though cause and effect have not been clearly demonstrated. The strongest evidence for association with heavy cannabis use and mental disorders is with what disease?

Schizo

Synthetic cannabinoids are created to mimic the effects of what?

delta 9 THC

Hemp is primarily differentiated from marijuana based of its contents of what?

delta 9 THC