How does Cannabinoids Works?
Type of Drug
Marijuana-like agents which reduce nausea and vomiting. Dronabinol as acts to increase appetite in patients with AIDS.
How the Drug Works
Dronabinol is the principal substance present in Cannabis sativa L (marijuana). Non-therapeutic effects of dronabinol are identical to those of marijuana and other cannabinoids. How the cannabinoids decrease nausea and vomiting and stimulate appetite is unknown.
Uses
To treat nausea and vomiting associated with cancer chemotherapy in patients who have failed to respond adequately to conventional antiemetic treatment. Dronabinol also is used in the treatment of anorexic .. associated with weight loss in patients with AIDS. Because the cannabinoids may alter the mental state, they are intended for use when the patient can be closely supervised.
Precautions
Hazardous tasks: Because of the effects on mental status, do not drive operate complex machinery or engage in any activity requiring judgment and unimpaired coordination while receiving treatment. Effects may persist for an unpredictable period of time. Dronabinol may persist in the body for days.
Supervision is required: Patients receiving cannabinoids should b observed in a doctor's office or hospital. This is especially important of naive treatment of naive patients. Even in patients experienced with mill juana, however, dronabinol may have serious responses not predicted by prior exposures. Any patient who has a psychotic experience will dronnblnol must be monitored until the mental state returns to normal. Additional doses should not be given until the patient has been examined and the circumstance evaluated.
Drug abuse and dependence: Dronabinol is highly abusable. Prescriptions are limited to the amount necessary for a single cycle of chemotherapy or to the amount necessary for the period between clinic visits. Long-term use of cannabinoids has been associated with disorders of motivation, judgment, and knowledge.
A withdrawal syndrome consisting of irritability, insomnia and restlessness was observed in some subjects within 12 hours following abrupt withdrawal of long-term dronabinol use. The syndrome reached its peak intensity at 24 hours when subjects exhibited hot flashes, sweating, runny nose, loose stools, hiccups, and appetite loss. The syndrome was essentially complete within 48 hours.
Electrocardiogram changes following discontinuation were consistent with a withdrawal syndrome. Several subjects reported disturbed sleep for several weeks after discontinuing high doses.
Pregnancy: Adequate studies have not been done in pregnant women. Use these drugs only if clearly needed.
Breastfeeding: Dronabinol appears in breast milk and is not recommended for use in nursing mothers.
Children: Dronabinol is not recommended for AIDS-related anorexia in children. Caution is recommended in prescribing this drug for children with chemotherapy-induced nausea and vomiting because of its pyschoactive effects.
Elderly: Use with caution in the elderly because of enhanced sensitivity to psychoactive effects.
Drug Interactions
Tell your doctor or pharmacist if you are taking or planning to take any overthe-counter or prescription medications or dietary supplements with cannabinoids. Doses of one or both drugs may need to be modified or a different drug may need to be prescribed. The following drugs and drug classes interact with cannabinoids.
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Alcohol anticholinergic agents (eg, atropine)
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Barbiturates (eg, phenobarbital)
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CNS depressants (benzodiazepines)
- Disulfiram (eg, Antabuse)
Side Effects
Every drug is capable of producing side effects. Many cannabinoid user experience no, or minor, side effects. The frequency and severity of sid effects depend on many factors including dose, duration of therapy, an individual susceptibility. Possible side effects include:
Digestive Tract: Nausea; vomiting; diarrhea; changes in appetite.
Nervous System: Drowsiness; heightened awareness; dizziness; unsteadiness; depression; weakness; hallucinations; memory loss; confusion; nightmares.
Circulatory System: Increased heart rate; lowered blood pressure.
Other: Dry mouth; vision problems (distortions); flushing.
Guidelines for Use
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Avoid alcohol and barbiturates. Use other drugs that cause drowsiness (eg, antianxiety agents, narcotic pain relievers) with caution.
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May cause dizziness, drowsiness, and impaired reflexes judgment. Do not drive or perform hazardous tasks requiring alertness.
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Possible changes in mood and other behavioral effects are possible with these drugs. Do not panic in the event of such manifestations.
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When taking dronabinol to stimulate appetite, take 1 hour before lunch or dinner; do not take before breakfast.
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Remain under supervision of a responsible adult.