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What is Marijuana
Marijuana is a term used to describe preparations derived from dried leaves and flowers of the Cannabis sativa or hemp plant.
The Cannabis sativa plant contains over 500 different compounds, approximately 100 of which are referred to as cannabinoids.
Cannabinoids are further classified into 3 subcategories: phytocannabinoids [e.g., delta-9-tetrahydrocannabinol (delta-9-THC), cannabidiol (CBD), cannabigerol (CBG), cannabichromene (CBC), cannabinol (CBN)]; endocannabinoids [e.g., arachidonylethanolamine (AEA) or anandamide, 2-arachidonylglycerol (2-AG)]; and synthetic cannabinoids.
These cannabinoids produce a variety of pharmacologic effects when ingested, chewed, or smoked; with delta-9-THC being the cannabinoid primarily responsible for the psychoactive properties of marijuana.
Marijuana is classified under the Federal Controlled Substance Act as a Schedule I botanical product. Despite being a Schedule I product, the FDA has approved 3 oral medications that contain active ingredients known to be present in botanical marijuana [e.g., Marinol (dronabinol, a synthetic form of delta-9-THC), Cesamet (nabilone), and Epidiolex (CBD)]. Further, the 2018 Farm Bill removed products derived from the hemp or Cannabis sativa plant from Schedule I status ONLY IF the cannabinoids produced by the plant contain no more than 0.3% delta-9-THC.
The federal Farm Bill does not affect state cannabis laws, which in many cases, conflict with federal laws. A majority of states and the District of Columbia have enacted laws to remove state-level criminal penalties for marijuana possession and use in patients with approved medical conditions.
The accepted medical conditions for which marijuana may be used vary from state to state; contact the specific state for their approved medical marijuana indication list and criteria for approved use.
Many states require patient registration, and county and city laws may also impact legal possession and use.
Approved state indications may include treatment of nausea or vomiting due to cancer (chemotherapy or radiotherapy) or HIV infection (e.g., due to medication treatment), glaucoma, muscle spasticity (multiple sclerosis, Crohn’s disease, or damage to spinal cord), seizures (epilepsy), chronic pain, peripheral neuropathy, arthritis, cachexia or wasting syndromes (e.g., AIDS/HIV), anorexia nervosa, migraine, hepatitis C, amyotrophic lateral sclerosis (Lou Gehrig’s disease), muscular dystrophy, nail-patella syndrome, post-traumatic stress disorder, agitation associated with Alzheimer’s disease, palliative care (e.g., hospice care or terminal illness resulting in less than 12 months of life), and serious or rare medical conditions for which the use of medical marijuana is beneficial.
Indications
- anorexia
- cachexia
- chemotherapy-induced nausea/vomiting
- glaucoma
- neuropathic pain
- spasticity
- Tourette’s syndrome
- tremor
For the treatment of chemotherapy-induced nausea/vomiting
Side Effects
- anemia
- anxiety
- appetite stimulation
- arrhythmia exacerbation
- ataxia
- blepharospasm
- bronchial secretions
- chest pressure syndrome
- confusion
- conjunctival hyperemia
- constipation
- cough
- depression
- diarrhea
- diplopia
- dizziness
- drowsiness
- dysarthria
- dysphoria
- dyspnea
- emotional lability
- euphoria
- fatigue
- fever
- growth inhibition
- gynecomastia
- hallucinations
- headache
- hypertension
- impaired cognition
- impotence (erectile dysfunction)
- infertility
- libido decrease
- menstrual irregularity
- myocardial infarction
- nausea
- nystagmus
- oligospermia
- orthostatic hypotension
- paranoia
- paresthesias
- peripheral vasodilation
- photophobia
- physiological dependence
- psychological dependence
- restlessness
- secondary malignancy
- stroke
- teratogenesis
- testicular atrophy
- tolerance
- tremor
- vomiting
- weakness
- weight gain
- wheezing
- withdrawal
- xerostomia
NOTE: Marijuana has not been approved by the FDA for any indication; no product is commercially available.
Monitoring Parameters
- urinalysis
Contraindications
- abrupt discontinuation
- asthma
- breast-feeding
- cardiac arrhythmias
- cardiac disease
- children
- chronic obstructive pulmonary disease (COPD)
- driving or operating machinery
- emphysema
- GI disease
- hypertension
- infants
- influenza
- lung cancer
- myocardial infarction
- neonates
- orthostatic hypotension
- pregnancy
- pulmonary disease
- reproductive risk
- respiratory infection
- stroke
Interactions
No information is available regarding drug interactions associated with Marijuana
