Cannabis and Cannabinoids

define cannabis and cannabinoids

what are the different “classes” of cannabis receptors

• Cannabis: Any preparation of leaves or flowers from the Cannabis genus.

• Contains 400+ phytochemicals, with 104+ classified as cannabinoids.

• Cannabinoids: Chemical compounds that act on cannabinoid receptors, influencing neurotransmission.

  • Exogenous (e.g., THC, CBD)

  • Endogenous (e.g., AEA, 2-AG)

main compounds in cannabinoids and their effects

4. Cannabis Species

• Sativa & Indica: _____

• Ruderalis (Hemp): _____

• High-THC, considered marijuana.

• Low-THC, used in industrial products (paper, textiles, oils).

4. Cannabis Species

• ___&____: High-THC, considered marijuana.

• _______: Low-THC, used in industrial products (paper, textiles, oils).

• Sativa & Indica

• Ruderalis (Hemp)

what year did cannabis become a schedule 1 drug?

what state was the 1st to re-legalize medical cannabis?

1971

california [then CO and WA legalized recreational use]

discuss the 2 main cannabinoid receptors

• CB1: CNS (hippocampus, amygdala, cortex) – linked to psychoactivity, addiction.

• CB2: Immune system – anti-inflammatory and immune regulation.

• Endocannabinoids: AEA (Anandamide) and 2-AG bind to ____.

• ______: Inhibits AEA degradation, interacts with 5-HT1A receptor (potential antidepressant effects).

• CB1/CB2

• CBD

Cannabis Pharmacology

• THC: ______

• CBD: ________.

• Entourage Effect: ________

• Psychoactive; CB1/CB2 partial agonist

• Non-psychoactive; inhibits reuptake of endocannabinoids, weak receptor affinity.

• Whole-plant synergy leads to greater effect than isolated compounds.

FDA-Approved Cannabinoid Medications

what is the evidence available about cannabis for pain relief, anxiety and sleep?

• Pain Relief:

  • Strong evidence supports cannabis for chronic pain (NASEM 2017).

  • Limited U.S. research due to federal restrictions and poor product match with market options.

• Anxiety:

  • Mixed and inconclusive evidence.

  • Some observational studies suggest benefits; others link heavy use to increased anxiety or social phobia.

• Sleep:

  • Moderate evidence supports benefit for sleep disturbances tied to pain/MS/OSA (NASEM).

  • Limited comparator studies.

research limitations include:

• Barriers: NIDA monopoly on research-grade cannabis, limited formulations, outdated delivery modes.

• we need to be able to:

  • Study alternate delivery methods

  • Compare standard vs. cannabinoid therapies

  • Establish therapeutic THC:CBD ratios

  • Use standardized, reproducible plant strains

T/F:

CBD:

• Legal if derived from hemp (de-scheduled 2018).

TRUE

BUT: Still federally restricted if derived from marijuana. [there is not really a way to know the difference]

• Florida’s medical marijuana Program (since 2016):

  • covers _________ conditions

  • requires what?

  • is it covered by medicare/medicaid?

• Covers cancer, ALS, PTSD, epilepsy, Parkinson’s, terminal illness, etc.

• Requires registry and specific physician dosing recommendations.

• Medicare/Medicaid do not cover cannabis.

Anesthesia Implications for cannabis use

• Cannabis use increases anesthetic requirements:

  • Propofol: +220% dosage

  • Fentanyl: +14%

  • Midazolam: +19.6%

Regular users require significantly higher sedation levels

Cannabinoid compounds include phytocannabinoids, endocannabinoids, and synthetics.

The two primary phytocannabinoids are _____&______, with CB1 receptors in the ___&___ and CB2 receptors in the ____&____ systems.

endocannabinoids- are ____produced in the brain or in peripheral tissues, and act on cannabinoid receptors

• delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD)

• brain and peripheral tissue

• immune and hematopoietic

• neurotransmitters

The route of delivery of cannabis is important as the _______and ____are very different for smoking versus oral/sublingual routes.

• bioavailability

• metabolism

which route of administration releases maximal levels of THC into blood within minutes,
peaking at 15-30 minutes, and decreasing within 2-3 hours

Inhalation by smoking or vaporization

T/F : cannabinoid receptors are present in all vertebrae animals but absent in invertebrates

TRUE

T/F: marijuana does not cross the placenta so it is safe for use during pregnancy

FALSE

it DOES- very lipophilic

Cannabis exposure sensitizes fetus to effects of alcohol

Deficits in behavior and cognition, including visual memory, language,
attention, and problem solving in childhood and adolescence