Your Dose of Cannabis Education

Your Dose of Cannabis Education

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Your Dose of Cannabis Education is based on data from the studies and reviews published in the current peer-reviewed medical journals. Whether you are a healthcare provider, patient, caregiver, an individual working in the healthcare sector, or just a curious person, you can benefit from Your Dose of Cannabis Education

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Do cannabinoids modify the metabolism of theophylline?
The combination of smoked marijuana and theophylline may lead to a decrease in theophylline levels.
Jusko WJ, Gardner MJ, Mangione A, Schentag JJ, Koup JR, Vance JW (1979). Factors affecting theophylline clearances: age, tobacco, marijuana, cirrhosis, congestive heart failure, obesity, oral contraceptives, benzodiazepines, barbiturates, and ethanol. J Pharm Sci 68: 1358 – 1366.
Experimental pain studies indicate that cannabinoids may be an effective therapy for acute and chronic pain. Have the results of clinical studies also shown that cannabinoids are effective at alleviating acute and chronic pain?
In contrast to experimental studies, the results of clinical trials with cannabinoids provide only moderate-quality evidence for the relief of chronic pain. Also, the analgesic effects of cannabinoids have not been found to be superior to placebo in acute pain. Importantly, pre-operative and peri-operative marijuana use may increase post-operative perceived pain.
Touil N, Lavand’homme P. Cannabis hyperalgesia-A phenomenon underestimated in the peri-operative period? Eur J of Anaes: Sept 2019. Vol 36. Issue 9. p 623-624
Patients are often instructed not to smoke marijuana for a few days prior to surgery. How readily do withdrawal symptoms develop?
In the case of chronic marijuana smokers, withdrawal symptoms can develop after just 1 day of not smoking marijuana. There are no general guidelines to treat the symptoms of marijuana withdrawal, but it has been reported that benzodiazepines and synthetic THC products (dronabinol, nabilone) used for the treatment of chemotherapy induced N/V may help alleviate some of the symptoms.
Alexander JC, Joshi GP. A review of the anesthetic implications of marijuana use. Proc (Bayl Univ Med Cent). 2019;32(3):364–371. Published 2019 May 21. doi:10.1080/08998280.2019.1603034
Do regular marijuana smokers who are undergoing anesthesia require higher doses of Propofol for the insertion of a laryngeal mask airway?
Yes. Results of a prospective, randomized, single blinded study, of regular marijuana users showed that higher doses of Propofol were needed to achieve loss of consciousness, adequate jaw relaxation and depression of airway reflexes for insertion of a laryngeal mask airway (LMA).
Flisberg P, Paech MJ, Shah T, et al. Induction dose of propofol in patients using cannabis. Eur J Anaesthesiol. 2009;26:192.
Are there any special considerations for patients who consume cannabinoid-based products and are undergoing plastic surgery?
Yes. On occasion, plastic surgeons administer medicines such as atropine and/or epinephrine during a procedure. Both of these medications can increase heart rate. Cannabinoids may potentiate the increase in heart rate.
Edalatpour A, Attaluri P, Larson JD. Medicinal and Recreational Marijuana: Review of the Literature and Recommendations for the Plastic Surgeon. Plast Reconstr Surg Glob Open. 2020 May 29;8(5):e2838. doi: 10.1097/GOX.0000000000002838. PMID: 33133899; PMCID: PMC7572176.

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