Cannabis

Cannabinoid receptors have been identified in human tissue. Cannabinoid type 1 (CB 1 ) receptors are found primarily in the CNS and peripheral nervous system; a key function of CB 1 receptors is to modulate release of the neurotransmitters glutamate and gamma-aminobutyric acid (GABA).( Grant 2018 ) CB 1 receptors are also found in the adrenal gland, bone marrow, and heart, liver, lung, reproductive, and vascular endothelial tissues. Type 2 receptors (CB 2 ) are found mainly in immune tissues but are also found in retinal, reproductive, and microglia cells.( Bari 2006 , Grant 2018 ) CB 1 and CB 2 receptors respond to endogenous cannabinoids, the most prevalent of which are 2-arachidonoylglycerol and arachidonoylethanolamine (also termed anandamide).( Di Marzo 2006 , Grant 2018 ) Natural (THC and CBD) cannabinoids act via the endocannabinoid system to suppress neuronal excitability and transmitter release, modulate cytokine release, and inhibit cyclooxygenase (COX) enzymes.( NCI 2017 ) The cannabinoid chemicals also act on cyclooxygenase, opioid receptors, adrenoreceptors, and voltage-gated potassium and sodium channels.( Gaston 2017 ) Using functional magnetic resonance imaging (MRI), a randomized clinical trial in healthy volunteers demonstrated positive correlations between THC administration and reduced functional connectivity between the amygdala and primary sensorimotor areas of the brain.( Lee 2013 ) The dissociative effects of THC in the brain are likely to play an important role in human pain relief and may have relevance in interpreting outcome measures reported in other clinical studies.( Lee 2013 )

Cannabinoid receptors have been identified in human tissue. Cannabinoid type 1 (CB 1 ) receptors are found primarily in the CNS and peripheral nervous system; a key function of CB 1 receptors is to modulate release of the neurotransmitters glutamate and gamma-aminobutyric acid (GABA).( Grant 2018 ) CB 1 receptors are also found in the adrenal gland, bone marrow, and heart, liver, lung, reproductive, and vascular endothelial tissues. Type 2 receptors (CB 2 ) are found mainly in immune tissues but are also found in retinal, reproductive, and microglia cells.( Bari 2006 , Grant 2018 ) CB 1 and CB 2 receptors respond to endogenous cannabinoids, the most prevalent of which are 2-arachidonoylglycerol and arachidonoylethanolamine (also termed anandamide).( Di Marzo 2006 , Grant 2018 ) Natural (THC and CBD) cannabinoids act via the endocannabinoid system to suppress neuronal excitability and transmitter release, modulate cytokine release, and inhibit cyclooxygenase (COX) enzymes.( NCI 2017 ) The cannabinoid chemicals also act on cyclooxygenase, opioid receptors, adrenoreceptors, and voltage-gated potassium and sodium channels.( Gaston 2017 ) Using functional magnetic resonance imaging (MRI), a randomized clinical trial in healthy volunteers demonstrated positive correlations between THC administration and reduced functional connectivity between the amygdala and primary sensorimotor areas of the brain.( Lee 2013 ) The dissociative effects of THC in the brain are likely to play an important role in human pain relief and may have relevance in interpreting outcome measures reported in other clinical studies.( Lee 2013 )

Cannabis is contraindicated in conditions like Ischemic heart disease, Pregnancy and Co-administration with dronabinol (Cannabis derivative)

The severe or irreversible adverse effects of Cannabis, which give rise to further complications include Panic attacks, Flashbacks. The symptomatic adverse reactions produced by Cannabis are more or less tolerable and if they become severe, they can be treated symptomatically, these include Tachycardia, Dry mouth, Psychosis, Tremor, Postural hypotension, Dizziness, Fatigue, Somnolence, Reduced coordination, Cognitive impairment, Euphoria, Paranoia, Mood alterations, Flushing, Xerostomia, Increased appetite, Oral candidiasis, Tooth discoloration.

Avoid cannabis during pregnancy. Avoid large doses of cannabis. Patients should observe caution while driving or performing tasks requiring alertness, because it may cause deterioration in motor co-ordination.

Drug should not be given to Paediatrics, Pregnant Mothers, and Neonates.If prescribing authority justifies the benefits of the drug against the possible damages he/she should reevaluate them and consult the reference material and previous studies.

0.035 mg/kg (0.035 (0.035)) 12 hourly PO — -

( ) — Not recommended in this age group

( ) — Not recommended in this age group

Few case reports exist of interactions in which cannabis is solely implicated. Cannabis may interact with the following: alcohol, anticholinergic agents, CNS depressants, cocaine, cytochrome P450 (CYP-450) 1A2 substrates, CYP2C9 inhibitors, CYP3A4 inducers and inhibitors, St. John's wort, sympathomimetics, and warfarin.

Cap Store in a well closed container, at room temperature, Below 25°C. Refrigeration and Freezing is not recommended.