cannabis

practice II final

legalization

• lawful to possess and use under certain conditions

• regulated by the state such as licensing and age restrictions

decriminalization

• still illegal but penalties reduced

• typically result in fines or civil penalties instead of jail time

FDA approved indications for synthetic dronabinol

• chemotherapy induced n/v

• AIDS related anorexia and weight loss

FDA approved indications for cannabidiol

• lennox-gastaut syndrome

• dravet syndrome

• tuberous sclerosis complex

endogenous cannabinoids

• produced in human body

• anandamide

• 2-arachidonoylglycerol (2-AG)

phytocannabinoids

• derived from plants

• delta-9-tetrahydrocannabinol THC

• cannabidiol CBD

CB1 receptors

• brain and CNS

• involved in psychoactive effects (euphoria, cognition, coordination)

CB2 receptors

• immune system, peripheral tissues, GI tract

• involved in inflammation and immune modulation

OK state law regarding medical marijuana card

• patients must have a state issued medical marijuana license

• no specific qualifying conditions required

• must purchase from state licensed dispensaries

• not allowed to use in public or drive under the influence

what are the allowed possession amounts

• 3 oz on a person

• 8 oz at home

• 1 oz on concentrate

• 72 oz of edibles

• 6 mature plants and 6 seedlings

drug-drug interactions with marijuana

• CBD inhibits CYP3A4 and CYP2C19

  • inc levels of clobazam and warfarin and antiepileptics

• additive CNS effects with alcohol, benzodiazepines, opioids, and antipsychotics

• caution with QT- prolonging medications

what marijuana dosage form carries highest risk of pediatric exposure

• edible formulations

• gummies, brownies, cookies

• attractive to children and easily mistaken for candy

symptoms of cannabinoid hyperemesis syndrome

• cyclic vomiting

• abdominal pain

• relief with hot showers or baths

treatment of cannabinoid hyperemesis syndrome

• stop cannabis use

• supportive care

• antiemetics and IV fluids if needed

what drugs can cause false positive on urine drug screen

• NSAIDs

• PPIs

• efavirenz

what drugs can cause false negative on urine drug screen

• dilution of urine

• delayed testing after last use

what are the PK principles of THC

• THC is lipophilic and accumulates in fat

• passes into breast milk

• long half life and slow elimination

what implications are there when using marijuana while breastfeeding

• potential neurodevelopmental risks to infant

• use is not recommended while breast feeding