Cannabis, Tobacco, and Vaping Final
What can reduce withdrawal symptoms of cannabis?
THC or other agonist no effect on relapse reduces withdrawal symptoms
Which treatment would you expect to show the most efficacy in the treatment of Huntington's disease? THC CBD THC:CBD
THC:CBD
Mechanism of CBD blocking pain
TRPV1 May block TNFa secretion (causes inflammation)
What causes tolerance in long-term use?
desensitization and downregulation
FAAH inhibitor trial
did not work no observation of reduced pain osteoarthritis pain is spontaneous pain
What system in activated from rewarding drugs?
dopamine system
Nociceptive Pain
due to tissue damage (arthritis)
What neurotransmitter do CB1 agonists decrease? What mediates this?
glutamate; COX2
Based on our current understanding, does CBD prevent seizures through its effects on glutamatergic or GABAergic neurons? glutamatergic GABAergic
glutamatergic
Do CB1 agonists increase or decrease ghrelin?
increase
Do FAAH inhibitors show an increase or decrease of weight in animal models?
increase
Do endocannabinoids increase or decrease during fasting?
increase
Rimonabant would be expected to ________ levels of melanocortin. increase decrease
increase
Would THC be expected to increase or decrease the measured time in a mouse tail-flick experiment? increase decrease
increase
In general, it appears that cannabis use _________ depressive symptoms. increases decreases
increases
Neuropeptide Y ________ appetite. increases decreases
increases
THC is equivalent to current ________ blockers for nausea and vomiting.
serotonin
Are high or low doses of THC expected to cause a larger reward response? high low
low
How much THC is required to give in an anti-emetic effect? high low
low
A cigarette smoker that has successfully quit smoking begins smoking marijuana. Does the make them more or less likely to restart smoking cigarettes? more likely less likely
more likely
Ghrelin
recognizes absence of food maintains CB1 receptors (wont stimulate but keeps it from decreasing)
Ajulmec acid
synthetic analog of THC metabolite cant cross BBB
Which statement best describes the physiological role of the endocannabinoid system in learning extinction? activation of the CB1 receptor increases learning extinction activation of the CB1 receptor decreases learning extinction blockade of the CB1 receptor increases learning extinction blockade of the CB1 receptor decreases learning extinction
Activation of the CB1 receptor increases learning extinction
A patient successfully uses regular, moderate consumption of CBD containing beverages to control general anxiety. This is most likely due to its ___________. inhibition of GABAergic neurons inhibition of glutamatergic neurons activation of TRPV1 receptors activation of the serotonin receptor
Activation of the serotonin receptor
With which current analgesic would cannabis show a synergistic effect? Aspirin Ibuprofen Ketamine Fentanyl Ice
Fentanyl
THCs pro-convulsant effects are most likely mediated through which type of neuron? GABAergic Glutamatergic
GABAergic
Chemo
Give mouse chemo to mimic neuropathic pain
Cannabis may be useful in the treatment of strokes by preventing neuron death caused by which mechanisms? Select all that apply. Ischemia Inflammation Excitotoxicity Autoimmune
Ischemia Inflammation Excitotoxicity
Is THC effective as an analgesic?
yes
Is cannabis addictive? yes no
yes
With our current knowledge, can cannabis be used to reduce psychotic symptoms? yes no we cannot tell with certainty
yes
You work for a company that has a strict "no-drugs" policy. A person that you are in the process of hiring takes a drug test that comes back positive for marijuana. They tell you that they have not consumed any form of cannabis or THC in the past few weeks. Is it possible that they are telling truth? yes no
yes
Does cannabis activate opioid system?
yes lessens withdrawal symptoms cannabis safer than opioids
With our current knowledge, does cannabis cause acute psychosis? yes no we cannot tell with certainty
yes (also well documented in persisten psychosis)
Cholecystokinin
tells us we are full decreases CB1 expression
In which region of the brain would you expect to see the effects of CB1 on the memory? The cortex (outside) the center the cerebellum the brain stem
the center
In what year did marijuana become outlawed at the federal level for all uses? 1961 1971 1972 2018
1971
Cannabinol
partial agonist less psychoactive than THC increases feeding in rats
For which source of pain would CBD be least effective as a single-agent therapy? A sprained ankle that still hurts a week after an accident multiple sclerosis patient in the ER with a gunshot wound
patient in ER with gunshot wound
From which source of pain would a CB2 agonist be least effective as a single-agent therapy? A sprained ankle that still hurts a week after an accident multiple sclerosis patient in the ER with a gunshot wound
patient in ER with gunshot wound
Endocannabinoids are primarily produced in ___________ neurons. presynaptic postsynaptic
postsynaptic
CB1 receptors are primarily found on ____________ neurons. presynaptic postsynaptic
presynaptic
Tetrahydrocannabivarin (THCV)
pure CB1 agonist similar effect to rimonabant no experimental evidence
For someone who has never smoked THC, how long will it remain in the body?
up to 2-5 days
What form of administration reduces toxin formation?
vaporizing
With our current knowledge, does cannabis use in adolescence cause adult psychosis? yes no we cannot tell with certainty
we cannot tell with certainty
With our current knowledge, does CBD use in adolescent appear to cause depression in adults? increase decrease we cannot tell with certainty
we cannot tell with certainty results are varied evidence of shared genetic predisposition
Which compound appears to be the primary endocannabinoid responsible for the reduction of nausea once it has occured? AEA 2-AG
2-AG
Which endocannabinoid exerts the largest control in the human body AEA 2-AG Vorodhamine Noladin ether
2-AG
Administration of which dose would be most likely to increase acute vomiting (ignore hyperemesis)? 1mg/kg THC 200mg/kg THC 1mg/kg CBD 200mg/kg CBD
200mg/kg CBD
Inhibition of FAAH causes an increase in which endocannabinoid?
AEA
Movement between states of normalcy and acute stress is controlled by the levels of which endocannabinoid? AEA 2-AG
AEA
What polymorphism can predispose individuals to the side effects of psychosis?
Catechol-O-methyltransferase (mixed evidence of polymorphism link in persistent psychosis)
The reward system received from eating is primarily dependent on which endocannabinoid receptor? CB1 CB2 TRPV1 GPR55
CB1
Which endocannabinoid receptor is responsible for the psychoactive effects of cannabis? CB1 CB2 TRPV1 GPR55
CB1
Which mice group showed increased object memory?
CB1 -/-
Based on our current knowledge, which would work best as an anti-emetic? CB1 agonist CB2 agonist CB1 antagonist CB2 antagonist
CB1 agonist
Which drug would be the most likely to show positive effect in the treatment of MS? CB1 agonist CB2 agonist CB1 antagonist CN2 antagonist
CB1 agonist
AM1710
CB2 agonist reduces neuropathic pain reduces TNFa no tolerance built
What is the composition of Epidiolex? THC CBD THC:CBD Cannabis extract
CBD
What can reverse psychosis caused by THC?
CBD (works better than FDA approved Amisulpride and safer)
What can block the effect of CBD?
CBG (cannabigerol)
Drugs that increase the expression of which class of drug metabolizing enzymes would be expected to decrease the half-life of THC in the body of users? SULTs GSTs UGTs MTs CYPs
CYPs
THCs effect on which intracellular molecule/ion has the most direct neuroprotective effect? Glutamate GABA Na+ K+ Ca2+
Ca2+
Does cannabis cause psychosis or does psychosis increase use of cannabis?
Can't tell cannabis users increase risk of developing psychosis later psychosis seems to increase risk of later cannabis use
What happens when endocannabinoids are overproduced and CB1 is overexpressed?
Constant increase in hunger
THC metabolites are primarily eliminated from the body through which process? Exhalation Urination Sweating Coughing Defecation
Defecation
_______ inhibitors increase AEA brain concentraion.
FAAH
Role of FAAH in pain management
FAAH inhibitors block acute and chronic pain FAAH deficient mics are less sensitive to pain No tolerance to inhibition Full FAAH inhibition and partial MAGL inhibition give analgesic effect
What process requires the CB1 receptor? Homeostatic Hedonistic
Hedonistic
Which term refers to the vegetative portion of a cannabis plant from a strain containing low levels of THC? Marijuana Hemp Hashish CBD
Hemp
Does HPA activity increase or decrease in infrequent users? Chronic users?
Increase; does not increase in chronic users but elevated basal activity
How does THC in adolescence effect adult depression?
Increases adult depression Downregulates CB1 receptors from incorrect development of CNS Positive allosteric modulator of CB1 rescues and reduces depression
Endocannabinoids most directly reduce the expression of which hormone? Neuropeptide Y Leptin Melanocortin
Leptin
What does leptin, Neuropeptide Y, and melanocortin do to appetite?
Leptin= decrease appetite Melanocortin= decrease appetite Neuropeptide Y= increase in appetite
What dose of THC was rewarding and what was aversive?
Low= rewarding High= aversive metabolism inhibitors not rewarding either
______ inhibitors increase 2-AG.
MAGL
Role of MAGL in pain management
MAGL inhibitors block acute and chronic pain Tolerance to MAGL inhibition
CBD
Mixed results Possible reduction in feeding if administered shorty before food
COMPASS study
One group of patients self-dosed other group continued normal treatment cannabis users reported significant decrease in pain no difference in severe adverse events
What CB1 antagonist can block opioid signaling?
Rimonabant
What drug increases olfactory and spatial memory in mice?
Rimonabant
How do endocannabinoids activate dopamine?
activates dopamine indirectly through inhibition of glutamate and GABA
Plantar test
arthritis inject irritant into paw to cause inflammation
THCA and CBDA
both more potent than their follower at reducing nausea and vomiting
What type of pain is the CB2 receptor involved in? acute chronic
chronic
Which experiment showed no effect?
delayed matching (light/lever experiment)
Which cannabinoids are psychoactive? Select all that apply delta9-THC-acid delta9-THC CBD CBD-acid
delta9-THC
Neuropathic
damage to nervous system (MS)
Activation of the CB1 receptor causes a(n) __________ in the production of cAMP. increase decrease
decrease
Do FAAH/MAGL inhibitors increase or decrease acute and anticipatory nausea?
decrease
Do THCV and CBDV increase or decrease nausea?
decrease
Is THC expected to increase or decrease short-term memory? increase decrease
decrease
Would aspirin, a COX inhibitor, increase or decrease the effects of THC?
decrease
Are AEA levels increased or decreased after anesthesia?
decreased
A patient successfully uses intermittent THC consumption to control panic attacks. This is most likely due to its _________. inhibition of GABAergic neurons inhibition of glutamatergic neurons activation of TRPV1 receptors activation of the serotonin receptor
inhibition of glutamatergic neurons
You take a blood sample from a long-term epilepsy patient immediately following a seizure. What levels of endocannabinoids do you expect to find? elevated reduced normal
normal
What type of pain is CBD better for?
not effective for acute pain but very effective for inflammatory and neuropathic chronic pain
Where in the body are endocannabinoids stored? Presynaptic vesicles Pituitary gland Nucleus acumbens Peripheral neurons They are not stored in the body
they are not stored in the body
A physician aims to reduce nausea in a patient using CBDA. Which route of administration of cannabis are they most likely to prescribe? smoking vaporization tincture topical
tincture