front 1 On average, .....of Canadians (4.4 million people) over the age of 15 have used cannabis in the past 12 months | back 1 15% 15-19 years: 19% |
front 2 Cannabis Pharmacology Consumed in many forms: -there are 2 main active | back 2 Delta-9-Tetrahydrocanabinol (aka THC) There are also thousands of other compounds, some active, some not |
front 3 THC | back 3 THC is the main psychoactive compound found in cannabis |
front 4 Shatter | back 4 Shatter is basically crystalized THC resin. Preparation of shatter is also dangerous as it requires high
temperatures so |
front 5 THC/SHATTER are EXTREMELY high in THC Substance induced psychosis is a real concern here | back 5 because THC is fat soluble, it stays in the body for a long time,
making the |
front 6 Endocannabinoid System: Two primary receptors in this system:(oncell surfaces) | back 6 CB1 receptors are found in the following areas in the body: |
front 7 CB2 receptors are found in? | back 7 Immune system (primarily) |
front 8 Action of CB Receptors | back 8 -Couple with G-Protein |
front 9 CB1 receptor: | back 9 -Reduces release of Ach, DA, GABA, glutamate, NA |
front 10 CB2 receptor: | back 10 Located on immune cells |
front 11 Acute THC Intoxication | back 11 Altered, more intense senses |
front 12 With high dose or potency | back 12 Hallucinations |
front 13 Management of Acute THC Intoxication Unintentional ingestion in children | back 13 More likely to have severe Cannabinoid-Induced Hyperemesis |
front 14 Mild intoxication | back 14 Supportive care is usually all that’s |
front 15 management of Severe THC intoxication with agitation | back 15 -Benzodiazepines are first line |
front 16 Long-Term Effects of Cannabis Use Use before 25 years: | back 16 Has been shown to impact brain |
front 17 Long-term cannabis use can also: | back 17 Impact executive functioning |
front 18 Cannabis in Pregnancy | back 18 -Primary active components: CBD and THC |
front 19 SOGC (Society of Obstetricians and Gynaecologists of Canada) position: Cannabis in Pregnancy | back 19 -most commonly used recreational drug in pregnancy in Canada |
front 20 Cannabis in Pregnancy: Impact on Outcomes | back 20 - In general, risk is unclear as the evidence is weak |
front 21 What is Cannabinoid-Induced | back 21 “Cannabinoid Hyperemesis Syndrome is characterized by chronic
cannabis use, cyclical episodes of nausea and |
front 22 Symptoms of CIHS what are the 3 phases? | back 22 3 Phases: |
front 23 Prodromal Phase | back 23 abdominal discomfort, early morning nausea, and anxiety
about |
front 24 Hyperemesis Phase episodes of nausea and vomiting. | back 24 Intractable and renders the patient incapacitated. |
front 25 Recovery Phase | back 25 all symptoms are mostly or completely resolved. |
front 26 Clues in the Diagnosis of CIHS | back 26 The patient frequently uses cannabis or cannabinoids Symptoms are relieved by a hot shower or bath Symptoms are eliminated when cannabis/cannabinoid use ceases Age <50 y/o is most common Significant weight loss (>5kg) Symptoms are worst in the morning during a hyperemesis episode All lab tests, radiography, and endoscopy tests lack significant findings Bowel activity is normal |
front 27 Rome IV Diagnostic Criteria for CIHS -Must include all of the following:...... -Criteria fulfilled for the last 3 months with symptom onset at
least 6 months -Supportive remarks: | back 27 1. Stereotypical episodic vomiting resembling cyclic vomiting
syndrome (CVS) in |
front 28 Proposed Pathophysiology | back 28 Dysregulation of the endocannabinoid system |
front 29 Why all this talk about hot showers? | back 29 -The endocannabinoid system is involved in many different processes
in the body |
front 30 trtment with hot showers or capsaicin | back 30 1. prolonged exposure to cannabinoids inactivates the TRPV1 receptor. 2.TRPV1 inactivation leads to nausea and emesis both via central effects and vagal afferents. 3.TRPV1 inactivation alters gastric motility. 4.cutaneous heat or capsaicin exposure normalizes gastric motility via activation of TRPV1 |
front 31 Evidence for Treatments: | back 31 The only treatment that has consistently been shown to work is
cannabis |
front 32 a new pilot study by dean et al. | back 32 Not amazing |
front 33 DSM-V Criteria: Substance Use Disorder | back 33 “A problematic pattern of [substance] use leading to |
front 34 Diagnosis of Cannabis Use Disorder | back 34 A problematic pattern of cannabis use leading to clinically
significant impairment or distress, as |
front 35 Treatment of Cannabis Use Disorder Non-pharmacological treatments: | back 35 Drug/addiction counseling |
front 36 Pharmacological treatments: | back 36 A few have been studied, to varying degrees of success: |
front 37 Gabapentin for Cannabis Use Disorder | back 37 -Thought to work in the amygdala and nucleus acumbens to help restore
GABA |
front 38 N-Acetylcysteine for Cannabis Use | back 38 Antioxidant precursor to glutathione |
front 39 Harm Reduction Measures for Cannabis Use | back 39 -any form of weed poses risks to your health. -the earlier u begin the greater the risk start later in life. -choose low strength prdts -dont use synthetic cannabis products. -smokin joints is harmful-to your lungs -do not inhale or hold your breath -limit use as much as possible -weed use impairs your ability to drive. -pple wit psychosis in their fam or pregnant shd not use -avoind combining any of the risky behaviours-they increase the chances of harming your health. |