Medical Cannabis and Cannabinoids最新文献

{"title":"Delta-9-Tetrahydrocannabinol and Cannabidiol Drug-Drug Interactions.","authors":"Paul T Kocis, Kent E Vrana","doi":"10.1159/000507998","DOIUrl":"10.1159/000507998","url":null,"abstract":"<p><p>Although prescribing information (PI) is often the initial source of information when identifying potential drug-drug interactions, it may only provide a limited number of exemplars or only reference a class of medications without providing any specific medication examples. In the case of medical cannabis and medicinal cannabinoids, this is further complicated by the fact that the increased therapeutic use of marijuana extracts and cannabidiol oil will not have regulatory agency approved PI. The objective of this study was to provide a detailed and comprehensive drug-drug interaction list that is aligned with cannabinoid manufacturer PI. The cannabinoid drug-drug interaction information is listed in this article and online supplementary material as a PRECIPITANT (cannabinoid) medication that either INHIBITS/INDUCES the metabolism or competes for the same SUBSTRATE target (metabolic enzyme) of an OBJECT (OTHER) medication. In addition to a comprehensive list of drug-drug interactions, we also provide a list of 57 prescription medications displaying a narrow therapeutic index that are potentially impacted by concomitant cannabinoid use (whether through prescription use of cannabinoid medications or therapeutic/recreational use of cannabis and its extracts).</p>","PeriodicalId":18415,"journal":{"name":"Medical Cannabis and Cannabinoids","volume":"3 1","pages":"61-73"},"PeriodicalIF":0.0,"publicationDate":"2020-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8489344/pdf/mca-0003-0061.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39539461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential Treatment for Overdose with Synthetic Cannabinoids.","authors":"Grant Meredith,&nbsp;Michael DeLollis,&nbsp;Mujeeb U Shad","doi":"10.1159/000506635","DOIUrl":"https://doi.org/10.1159/000506635","url":null,"abstract":"Emergency departments are increasingly reporting overdoses with synthetic cannabinoids (SCs), such as K2 and Spice, presenting not only as agitation, paranoia, anxiety, and confusion, but also medical complications, such as palpitations, hypertension, nausea, vomiting, and seizures [1]. Multiple deaths have also been reported with SC overdoses [2]. One of the reasons for such high level of toxicity with SCs is their potent agonist activity at cannabinoid type-1 (CB1) receptor without any action on the cannabinoid type-2 (CB2) receptor, which further adds to the adverse effect profile of SCs, as CB2 receptors have been shown to neutralize some of the CB1 receptor activation. However, in contrast to SCs, delta-9-tetrahydrocannabinol (THC; primary psychoactive substance in botanical marijuana) is a partial agonist at CB1 and CB2 receptors. We believe that it is the difference between partial and full agonism at CB1 receptors that makes the SCs so much more toxic than botanical marijuana or THC. In addition, SCs have longer half-lives along with active metabolites, whereas THC is primarily metabolized into the inactive metabolite 11-nor-9-carboxy-9-tetrahydrocannabinol (THC-COOH). Additionally, the effects of THC in botanical marijuana may also be modified by the presence of other cannabinoids and terpenes within the plant [3]. Cannabidiol (CBD) is another important psychoactive agent in marijuana (usually present at much lower concentrations than THC), which is neither an agonist nor a partial agonist but modifies CB1 receptor activity via allosteric modulation [1]. It is shown to be nonaddictive and safe as reflected by LD50, which is more than 100 times greater than the oral dose [3]. More importantly, CBD has also been shown to have preliminary evidence in the management of atonic seizures [4], social anxiety [5], and psychosis in patients with Parkinson’s disease [6]. In addition, CBD is the only marijuana agent that has been approved by the FDA to manage treatment-refractory seizures in children. Although it is theoretically plausible that partial agonism with THC may neutralize some of the neurotoxic effects of SCs, CBD represents a safer and more acceptable approach to neutralize toxic effects of SCs due to its nonaddictive potential and selective allosteric modulation of CB1 receptors. In this context, CBD may provide a specific antidote to the neurotoxicity with SCs [7]. More importantly, approval of CBD formulation (i.e., EpidiolexTM) can ensure qualitative and quantitative monitoring by the FDA. Therefore, we propose to explore CBD treatment to manage overdose and toxicity with SCs, which is increasingly recognized as a life-threatening emergency, especially in the emergency settings across the United States.","PeriodicalId":18415,"journal":{"name":"Medical Cannabis and Cannabinoids","volume":"3 1","pages":"74-75"},"PeriodicalIF":0.0,"publicationDate":"2020-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000506635","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39539460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abstracts - CannX: The International Medical Cannabis Conference Lisbon, Portugal, February 12-13, 2020","authors":"C. Rundle, S. Dercon, P. Lio, J. Fernandez, M. Fujita, R. Dellavalle","doi":"10.1159/000505827","DOIUrl":"https://doi.org/10.1159/000505827","url":null,"abstract":"Cancer is the second leading cause of death globally and is responsible for an estimated 9.6 million deaths in 2018. Reported cases of cancer in both genders are 18.78 million in 2018 with ap-proximately 70% of deaths occurring in low- and middle-income countries, including Pakistan. Breast cancer is the highest reported cancer in Pakistan while prostate cancer constitutes 6.7% of the total cancer burden. Anti-cancer activity of selected plant-derived cannabinoids has been studied in different cancer cell lines showing positive results by some investigators but there is no such report available from Pakistan and the therapeutic potential of Pakistani varieties of Cannabis Sativa remains unexplored. We infer that the variant of C. sativa cultivated in Pakistan is efficacious against human breast cancer and prostate cancer cell lines. This study is planned to evaluate the anticancer properties of different extracts (Flowers, leaves, stem, root, seeds and whole plant extracts) of Cannabis Sativa cultivated in Pakistan against human breast cancer cell lines (MCF-7 and MDA-MB-231) and prostate cancer cell lines (PC3 and LNCaP). All plant material will be dry and powdered in pharmacology laboratory. Each plant material will be soaked in aqueous methanol (30:70) for three days at room temperature and 1st, 2nd, and 3rd filtrates will be obtained using a muslin cloth and Whatman filter paper. The filtrates will be com-bined together and solvent will be removed using a rotary-evapo-rator under reduced pressure, to yield/obtained respective Cannabis sativa thick extract. An intramural grant has been procured for this study. Results will be shared during the research presentation. Delta-9-tetrahydrocannabinol (THC) is the main phytocan-nabinoid in “Cannabis sativa”. Cannabis use by pregnant women to relieve morning sickness has been increasing, as reported by various epidemiological studies. Diverse processes are involved in the remodelling of trophoblast cells, such as proliferation, differentiation, apoptosis and invasion, which are crucial for placental development. The consumption of cannabis during pregnancy is of much concern since it may disrupt the endocannabinoid system (ECS) which modulates several biological functions, including re-production. Our group demonstrated that THC has an impact on trophoblast turnover, through induction of apoptosis, as well as on the ECS homeostasis. Considering the relevance of cannabinoid signalling in reproductive tissues, women of child-bearing age may be a particularly sensitive group to cannabinoids exposure. Thus, it is important to understand the consequences of this exposure on reproductive health. The aim of this work was to study the effects of THC on trophoblast cells, using BeWo and HTR-8 (ATCC, USA) cell lines, well-accepted models of cytotrophoblasts (“stem cells”) and extravillous/invasive trophoblasts, respectively. It was observed that THC induces a dose-dependent decrease in cell vi-ability although ","PeriodicalId":18415,"journal":{"name":"Medical Cannabis and Cannabinoids","volume":"3 1","pages":"116 - 131"},"PeriodicalIF":0.0,"publicationDate":"2020-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000505827","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48610729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Evaluation of Regulatory Regimes of Medical Cannabis: What Lessons Can Be Learned for the UK?","authors":"Anne Katrin Schlag","doi":"10.1159/000505028","DOIUrl":"https://doi.org/10.1159/000505028","url":null,"abstract":"<p><p>This paper evaluates current regulatory regimes of medical cannabis using peer-reviewed and grey literature as well as personal communications. Despite the legalization of medical cannabis in the UK in November 2018, patients still lack access to the medicine, with fewer than 10 NHS prescriptions having been written to date. We look at six countries that have been at the forefront of prescribing medical cannabis, including case studies of the three largest medical cannabis markets in the EU: Germany, Italy, and the Netherlands. Canada, Israel and Australia add global examples. These countries have a more successful history of prescribing medical cannabis than the UK. Their legislations are outlined and numbers of medical cannabis prescriptions are provided to give an indication of how successful their regulatory regime has been in providing patient access. Evaluating countries' medical cannabis regulations allows us to offer implications for lessons to be learned for the development of a successful medical cannabis regime in the UK.</p>","PeriodicalId":18415,"journal":{"name":"Medical Cannabis and Cannabinoids","volume":"3 1","pages":"76-83"},"PeriodicalIF":0.0,"publicationDate":"2020-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000505028","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39539462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a Vaping Machine for the Sampling of THC and CBD Aerosols Generated by Two Portable Dry Herb Cannabis Vaporisers.","authors":"Laura Carrara,&nbsp;Christian Giroud,&nbsp;Nicolas Concha-Lozano","doi":"10.1159/000505027","DOIUrl":"10.1159/000505027","url":null,"abstract":"<p><p><i>Cannabis sativa</i> is known for its recreational use, but also for its therapeutic potential. There has been wide discussion over the use of cannabis for medical purposes in recent years, especially because a consensus has not been reached regarding its risk/benefit balance. Among the more common modes of administration, vaping with a vaporiser is most frequently used for self-medication. Vaping seems to be a better alternative to preventing adverse health effects due to toxic compounds produced during combustion when cannabis is smoked. However, the delivery kinetics and efficiency of most portable vaporisers are not fully characterised with an appropriate vaping regime. This determination requires a specific vaping machine operating under realistic puffing conditions. In this study, a vaping machine was conceived to fit with the common uses of portable vaporisers that requires conditions different from those used for electronic cigarettes. The experimental setup in this study was optimised to sample aerosolised cannabinoids. The delivery kinetics, efficiency, and decarboxylation yields of two commercially available vaporisers (DaVinci® and Mighty Medic®) were evaluated for delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD). Among all tested sampling supports, the glass fibre filter is the most efficient medium to collect mixed THC and CBD aerosols. From the delivery kinetics of cannabinoids, a single-parameter model was used to calculate the extraction coefficient of each vaporiser. The results show that the Mighty Medic® vaporiser had a higher extraction coefficient (0.39) and a more immediate release of cannabinoids than the DaVinci® vaporiser (0.16), which had a gradual and slower rate of vaporisation. This parameter could be a quantitative input in pharmacokinetic models of administration of volatile compounds using vaporisers and a useful tool for the comparison of vaporisers.</p>","PeriodicalId":18415,"journal":{"name":"Medical Cannabis and Cannabinoids","volume":"3 1","pages":"84-93"},"PeriodicalIF":0.0,"publicationDate":"2020-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000505027","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39539463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Screening for More than 1,000 Pesticides and Environmental Contaminants in Cannabis by GC/Q-TOF.","authors":"Philip L Wylie,&nbsp;Jessica Westland,&nbsp;Mei Wang,&nbsp;Mohamed M Radwan,&nbsp;Chandrani G Majumdar,&nbsp;Mahmoud A ElSohly","doi":"10.1159/000504391","DOIUrl":"10.1159/000504391","url":null,"abstract":"<p><p>A method has been developed to screen cannabis extracts for more than 1,000 pesticides and environmental pollutants using a gas chromatograph coupled to a high-resolution accurate mass quadrupole time-of-flight mass spectrometer (GC/Q-TOF). An extraction procedure was developed using acetonitrile with solid phase extraction cleanup. Before analysis, extracts were diluted 125:1 with solvent. Two data mining approaches were used together with a retention-time-locked Personal Compound Database and Library (PCDL) containing high-resolution accurate mass spectra for pesticides and other environmental pollutants. (1) A Find-by-Fragments (FbF) software tool extracts several characteristic exact mass ions within a small retention time window where the compound elutes. For each compound in the PCDL, the software evaluates the peak shape and retention time of each ion as well as the monoisotopic exact mass, ion ratios, and other factors to decide if the compound is present or not. (2) A separate approach used Unknowns Analysis (UA) software with a peak-finding algorithm called SureMass to deconvolute peaks in the chromatogram. The accurate mass spectra were searched against the PCDL using spectral matching and retention time as filters. A subset PCDL was generated containing only pesticides that are most likely to be found on foods in the US. With about 250 compounds in the smaller PCDL, there were fewer hits for non-pesticides, and data review was much faster. Organically grown cannabis was used for method development. Twenty-one confiscated cannabis samples were analyzed and ten were found to have no detectable pesticides. The remaining 11 samples had at least one pesticide and one sample had seven detectable residues. Quantitative analysis was run on the confiscated samples for a subset of the pesticides found by screening. Two cannabis samples had residues of carbaryl and malathion that were estimated to be about 10 times greater than the highest US Environmental Protection Agency tolerance set for food and about 4,000 times greater than the Canadian maximum residue limits for dried cannabis flower.</p>","PeriodicalId":18415,"journal":{"name":"Medical Cannabis and Cannabinoids","volume":"3 1","pages":"14-24"},"PeriodicalIF":0.0,"publicationDate":"2020-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000504391","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39539458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurological Improvement with Medical Cannabis in a Progressive Supranuclear Palsy Patient: A Case Report.","authors":"Ana Gabriela Hounie, Marco Agassiz Almeida Vasques","doi":"10.1159/000503864","DOIUrl":"10.1159/000503864","url":null,"abstract":"<p><p>Progressive supranuclear palsy (PSP) is a severe, debilitating, and often fatal disease resembling other neurodegenerative disorders, namely Alzheimer's (AD) and Parkinson's (PD) diseases, which have been successfully treated with cannabinoids. We herein report the case of a 71-year-old woman diagnosed with PSP, displaying severe impairment of motor and language functions which progressively improved after treatment with medical cannabis. Before treatment, the patient was unable to move her limbs, was fed soft food, and was unable to speak or move her eyes. The patient has regained horizontal eye movement, is able to walk with assistance, has returned to physiotherapy, started to eat solid food, and has had a remarkable improvement in her speech. The possible mechanisms of this improvement are discussed.</p>","PeriodicalId":18415,"journal":{"name":"Medical Cannabis and Cannabinoids","volume":"2 2","pages":"65-68"},"PeriodicalIF":0.0,"publicationDate":"2019-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8489313/pdf/mca-0002-0065.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39539456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abstracts - 4th International Medical Cannabis Conference (CannX 2019) Tel Aviv, Israel, September 9-10, 2019","authors":"","doi":"10.1159/000502323","DOIUrl":"https://doi.org/10.1159/000502323","url":null,"abstract":"","PeriodicalId":18415,"journal":{"name":"Medical Cannabis and Cannabinoids","volume":"2 1","pages":"84 - 103"},"PeriodicalIF":0.0,"publicationDate":"2019-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000502323","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46944648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Construction and Validation of Quantification Methods for Determining the Cannabidiol Content in Liquid Pharma-Grade Formulations by Means of Near-Infrared Spectroscopy and Partial Least Squares Regression.","authors":"Joan Espel Grekopoulos","doi":"10.1159/000500266","DOIUrl":"https://doi.org/10.1159/000500266","url":null,"abstract":"<p><p>There is an increasing interest in cannabinoids as they are being proved to effectively treat the symptoms of a variety of medical conditions. Commercialization of cannabinoid-based pharmaceutical products is expected to grow in the near future, favored by the recent changes in medical regulations in many developed countries. Hence, robust and reliable analytical methods for determining the content of the active pharmaceutical ingredient will be needed, as this is one of the most relevant parameters for the decision to release the final pharmaceutical product into the market. The aim of this work was to demonstrate that near-infrared (NIR) spectroscopy fulfills the needed requirements for this purpose, as well as to provide a methodology to be applied to other cannabinoid-based products. We present two validated methods for the quantification of different liquid pharma-grade cannabidiol (CBD) formulations based on NIR spectroscopy and partial least squares regression modelling. The methods were constructed and validated with spectra belonging both to production samples and to laboratory samples specifically made for this purpose, and they fulfill European Medicines Agency and International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use guideline requirements. These methods allow determining the CBD content with results comparable to the usual method of choice while saving reagent- as well as time-related costs.</p>","PeriodicalId":18415,"journal":{"name":"Medical Cannabis and Cannabinoids","volume":"2 1","pages":"43-55"},"PeriodicalIF":0.0,"publicationDate":"2019-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000500266","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39542022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cannabinoids in Gynecological Diseases.","authors":"Petra Luschnig,&nbsp;Rudolf Schicho","doi":"10.1159/000499164","DOIUrl":"https://doi.org/10.1159/000499164","url":null,"abstract":"<p><p>The endocannabinoid system (ECS) is a multifunctional homeostatic system involved in many physiological and pathological conditions. The ligands of the ECS are the endo-cannabinoids, whose actions are mimicked by exogenous cannabinoids, such as phytocannabinoids and synthetic cannabinoids. Responses to the ligands of the ECS are mediated by numerous receptors like the classical cannabinoid receptors (CB₁ and CB₂) as well as ECS-related receptors, e.g., G protein-coupled receptors 18 and 55 (GPR18 and GPR55), transient receptor potential ion channels, and nuclear peroxisome proliferator-activated receptors. The ECS regulates almost all levels of female reproduction, starting with oocyte production through to parturition. Dysregulation of the ECS is associated with the development of gynecological disorders from fertility disorders to cancer. Cannabinoids that act at the ECS as specific agonists or antagonists may potentially influence dysregulation and, therefore, represent new therapeutic options for the therapy of gynecological disorders.</p>","PeriodicalId":18415,"journal":{"name":"Medical Cannabis and Cannabinoids","volume":"2 1","pages":"14-21"},"PeriodicalIF":0.0,"publicationDate":"2019-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000499164","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39542019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}