The indications for nabilone include the treatment of nausea and vomiting associated with cancer chemotherapy in patients who have failed to respond adequately to conventional antiemetic treatments. Is nabilone an effective treatment for post-operative nausea and vomiting?
No. Nabilone has not been found to be an effective treatment for PONV. Intravenous THC has not been shown to be an effective tretment for PONV either.
True or false? Patients who consume marijuana with a high THC concentration in the acute pre-operative period, may be at increased risk of a violent emergence from general anesthesia.
This statement is true, especially for the patients who experienced THC-induced anxiety, paranoia or psychosis in the pre-operative period.
Do some cannabinoids cause a prolongation of anesthetic duration?
Some do and some don’t…. A study in mice with pure extracts of THC, CBD, and CBN showed that while THC and CBD were both associated with an additive prolongation of anesthetic duration, CBN extracts actually blunted this anesthetic prolongation.
True or false? The total dose of THC contained within a marijuana cigarette is dependent upon the proportion of buds, stems, leaves and seeds within the marijuana.
True. The amount of THC in one part of the cannabis plant differs from that of another part of the same cannabis plant.
Once a patient has refrained from cannabis use for several months and he/she is asymptomatic, is there a risk of recurrence, if the patient starts using cannabis again?
Yes.There can be a resurgence of the syndrome with resumption of cannabis use. Because most patients are lost to follow up, the actual incidence of resurgence is unknown. It has been suggested that part of the treatment plan for cannabinoid hyperemesis syndrome should include a referral to a drug rehabilitation facility.
What are the laboratory markers that would indicate the diagnosis of cannabinoid hyperemesis syndrome?
Actually, there are no suggestive laboratory markers that would readily indicate the possible diagnosis of this syndrome.Medical practitioners can order extensive testing and obtain little useful information from ultrasounds, CT scans, endoscopies, barium studies and blood lab work.
Hot showers reportedly decrease the nausea and vomiting associated with cannabinoid hyperemesis syndrome.Do these hot showers decrease the intensity of some of the other symptoms of this syndrome?
Yes.Hot showers reportedly decrease the abdominal pain and food aversion experienced by the patients.
Compare the technology of conduction-based vaporizers to convection-based vaporizers.
The technology of the convection vaporizers is more advanced and offers more accurate temperature controls and greater efficiency of vaporization. With convection vaporization, the herbal material is more evenly heated and there is a lower risk of combustion and burning of the herbal material. Unlike conduction vaporization, convection vaporization does not require the stirring or shaking of the herbal material between inhalation draws. Convection vaporizers are typically more expensive and require a slightly longer period of time to vaporize the herbal material.
According to the European Pain Federation position paper on appropriate use of cannabis-based medicines and medical cannabis for chronic pain management, is it prudent to prescribe cannabis‐based medicines to patients taking high doses of opioids or benzodiazepines?
At what doses of THC would an individual experience psychotropic effects?
According to Health Canada’s document entitled Information for Health Care Professionals: Cannabis and Cannabinoids,“It has been estimated that an inhaled dose of 0.045 –0.1 mg/kg of THC … would be sufficient to reach the threshold for psychotropic effects.” “For oral administration, a dose of 0.15 – 0.3 mg/kg of THC (i.e. an individual oral dose of 10 – 20 mg THC) would be sufficient to reach the threshold for psychotropic effects.”
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