Nevertheless, careful monitoring of patients who are concomitantly consuming cannabis/cannabinoids and other medications that are metabolized by the above-mentioned enzymes may be warranted. As mentioned, Δ9-THC accumulates and is retained in fatty tissue, and its release from this storage site into the blood is slowReference 453. It is also not entirely certain if Δ9-THC persists in the brain (a highly fatty tissue) in the long-term; however, the presence of residual cognitive deficits in abstinent heavy cannabis users suggests this may be the case, at least in the short-termReference 457Reference 458. This finding lends further support to the evidence on the distribution, accumulation, and storage of THC (and metabolites) in the adipose tissue and CBD gummies for sale the slow release of THC (and metabolites) from adipose tissue stores back into the bloodstreamReference 229.
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Cases of ST-elevation MI, although rare, have been reported following the use of K2 in patients as young as 14 years old as well as in adults . On the other hand, Orsini et al. reported a case of non-ST-segment elevation MI leading to acute congestive heart failure (CHF) and acute hypoxemic respiratory failure, after consumption of SCs . They hypothesized that consumption of K2 caused transient myocardial ischemia resulting in ventricular stunning leading to acute CHF . Shah et al. reported a case of AMI with left ventricular apical thrombus that could only be attributed to smoking marijuana and Spice in a 24-year-old male patient. Development of acute ischemic strokes due to consumption of SCs has also been reported in young adults without any history of predisposing factors .
In one case, THC concentration in the brain was 19.4 ng/g, while the blood concentration of THC was 4.4 ng/mL. In another case, brain THC concentration was 29.9 ng/g where the THC concentration in the blood was ≤ 0.2 ng/mLReference 458. Furthermore, examination of specific brain areas showed significant accumulation of THC and 11-hydroxy-THC in the substantia nigra, hippocampus, the occipital lobe, the striatum-putamen-pallidum, the frontal lobe, spinal cord and corpus callosum, the cortex and the white matterReference 458.
Results from a survey carried out among glaucoma patients at tertiary glaucoma clinics in Toronto and Montreal suggested that approximately 13% of these patients claimed they used complementary and alternative medicines to treat glaucoma, and from among these patients 2.3% reported using cannabis to treat their glaucomaReference 978. There is emerging evidence of a role for the ECS in the pathophysiology of spinocerebellar ataxiasReference 967Reference 968.
Furthermore, the 6.2 mg and the 62.3 mg gel doses of CBD significantly reduced joint swelling, limb posture scores as a rating of spontaneous pain, immune cell infiltration and thickening of the synovial membrane. The 6.2 mg dose of CBD optimally reduced swelling and synovial membrane thickness. CBD treatment was not associated with changes in exploratory behaviour suggesting the lack of psychoactive effects. One multi-centre, randomized, double-blind, double-dummy, placebo- and active-controlled crossover clinical trial of a FAAH inhibitor reported a lack of analgesic activity (Western Ontario and McMaster Universities pain score) in patients with OA of the kneeReference 899. In contrast, administration of naproxen in the study was associated with significant analgesia.