Table 6: Marijuana-derived Pharmaceutical Products Generic Name Brand Name FDA Status
FDA-Approved or Under Review Indications Appetite stimulant in management of anorexia associated with AIDS Treatment of chemotherapy- induced nausea/ vomiting Treatment and prevention of chemotherapy- induced nausea/ vomiting Treatment of Lennox- Gastaut syndrome, Dravet syndrome, and tuberous sclerosis complex cancer patients who experience inadequate analgesia during optimized chronic opioid therapy Clinical trials for pain treatment in
Pharmacology
Dronabinol
Marinol
FDA-approved controlled substance Schedule Ill
Synthetic delta-9- tetrahydrocannabinol (delta-9-THC) is the primary active compound of marijuana
THC
Syndros (capsules)
Nabilone
Cesamet (capsules)
FDA-approved controlled substance Schedule II
Derivative of cannabinol, a nonpsychoactive constituent of marijuana
Cannabidiol (CBD)
Epidolex (oral solution)
Descheduled by the DEA; no longer subject to the CSA
Plant-derived cannabidiol (CBD), accounting for 40% of cannabis extracts Combination of delta- 9-THC, the primary active compound, and cannabidiol, a nonpsychoactive component of marijuana
Cannabidiol (CBD) and delta-9- Tetrahydrocannabinol
Sativex (oromucosal spray)
Under investigation in the United States, Phase II/III trials
Case study 4 Mr. and Mrs. Jones bring in their teenage son for evaluation. His school performance has declined recently, and Mrs. Jones is concerned that he “vapes” and reports that he admitted occasionally using marijuana in the vape device. He states that he uses it to “relax” sometimes and that he would be doing worse without it. He states that it is legal, so that it must not be that bad. Questions 1. What information could you share with the Joneses and their son regarding the potential risks of marijuana in all its forms? _______________________________________________________________________________________________ 2. The Joneses have questions regarding the legality of the use of marijuana and ask whether a prescription for medical marijuana would be appropriate. Would it? _______________________________________________________________________________________________ OPIOIDS Both “opiate” and “opioid” have commonly been
class stems from its powerful ability to control pain and induce euphoria. Opioid use disorder (OUD) has reached epidemic proportions with substantial negative impacts on society. OUD is a chronic, relapsing disease influenced by genetics, stress response, and prior experimentation or exposure. 63 Mu opioid receptors (MORs) modulate nociception, stress, temperature, respiration, endocrine activity, memory, mood, and motivation. MORs bind opioids
used interchangeably in the past, but current accepted practice is to specifically use the term “opioids” to refer to all natural, semisynthetic, and synthetic forms of this centuries-old agent of pain control. Fentanyl, the most prevalent synthetic opioid today, is included in this category along with naturally occurring opioid formulations such as heroin, morphine, and codeine. The popularity of this drug
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Book Code: TN24CME
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