Historical overview
G. Hussein Rassool in Alcohol and Drug Misuse, 2017
Cannabis Sativa (or Indian hemp), more commonly known as cannabis or marijuana was one of the first plants to be cultivated for its non food properties, and was primarily harvested for its fibre. It is thought to have originated in Asia, around 2700 B.C. in China. It was recommended for its pharmacological properties by the Emperor Shen Nung to his citizens for the treatment of pain, gout, absentmindedness and other ailments (Maisto et al. 1995). In addition, it has been speculated cannabis was also used for countering of evil spirits and for its psychoactive properties (Abel 1980). With the spread of cannabis to neighbouring countries, in India, this psychoactive substance was regarded as a sacred plant and used for religious function and ritual. Whereas marijuana is the leafy top portion of the plant, hashish, made from the resin, was identified amongst the Arabs around the tenth century (Abel 1980). The use of the drug for its recreational and intoxicating effects appears to be related to the Middle East and North Africa. The drug most probably first reached European countries in the 19th century following the Arab invasion of Spain.
Recent Cannabinoid Delivery Systems
Betty Wedman-St Louis in Cannabis as Medicine, 2019
Cannabis (cannabis sativa) is a dioic plant that belongs to the Cannabaceae family (Magnoliopsida, Urticales). Knowledge of the medical and psychoactive properties of cannabis dates back to 4000 B.C. All of the different varieties of cannabis, including the one known as cannabis indica, belong to the same species. All C. sativa plants produce active compounds, but each variety produces these compounds in different concentrations and proportions, which do not only depend on genomic background, but also on growing conditions and climate, meaning that they can be referred to as chemical varieties or chemovars, rather than strains [1]. Each chemovar contains varying concentrations of cannabinoids, a class of mono- to tetracyclic C21 (or C22) meroterpenoids. While more than 100 different cannabinoids can be isolated from C. sativa, the primary psychoactive compound is Δ9-tetrahydrocannabinol (THC), which was first isolated in its pure form by Gaoni & Mechoulam in 1964 [2]. Other pharmacologically important analogues are: cannabidiol (CBD), cannabinol, cannabinoid acids, cannabigerol, and cannabivarins. In addition to cannabinoids, other components, such as monoterpenoids myrcene, limonene, pinene, and sesquiterpenoid beta-caryophyllene, can also mediate the pharmacological effects of C. sativa [3].
Refractory Cancer Cachexia
Victor R. Preedy in Handbook of Nutrition and Diet in Palliative Care, 2019
Throughout history mankind has used extracts from the plant Cannabis sativa as a recreational and therapeutical drug. Endocannabinoids are involved in the natural regulation of appetite. The synthetic cannabinoid dronabinol (Delta-9THC) is approved as an antiemetic drug and as an appetite stimulant in HIV wasting. In cancer cachexia, after promising phase II trial results, two large placebo-controlled trials showed no clear improvement in appetite or quality of life (Strasser et al. 2006). Psychological symptoms like confusion and somnolence, and physiological symptoms like tachycardia or hypotension occur in terms of adverse effects. In selected patients with predominantly chronic nausea or anxiety, the use of cannabinoids can be an option.
What role do cannabinoids have in modern medicine as gastrointestinal anti-inflammatory drugs?
Published in Expert Opinion on Pharmacotherapy, 2020
Adrian Szczepaniak, Jakub Fichna
Cannabis sativa, also known as marijuana, has been cultivated and used forcenturies for recreational and medicinal purposes. Cannabis plant contains at least 60 cannabinoids and several other compounds such as terpenoids, flavonoids, or alkaloids [2]. The main psychoactive substance in C. sativa is Δ9-tetrahydrocannabinol (THC) but it also contains pharmacologically relevant cannabidiol (CBD), tetrahydrocannabivarin, cannabichromene, and cannabigerol. Cannabis extracts have been used throughout centuries for a variety of diseases due to their anti-inflammatory, antiemetic, antidiarrheal, and analgesic properties. In addition to plant-derived compounds, there are two other classes of cannabinoids – synthetic (e.g. WIN55212-2) and endogenous such as anandamide (AEA) and 2-arachidonoylglycerol (2-AG) [3]. Overall, cannabinoid-based drugs are used mainly in chronic diseases where standard treatment does not have positive effects [4]. Cannabinoids can be administered in many ways, including oral, sublingual, inhaled, or local.
Cannabis as a potential compound against various malignancies, legal aspects, advancement by exploiting nanotechnology and clinical trials
Published in Journal of Drug Targeting, 2022
Nazeer Hasan, Mohammad Imran, Afsana Sheikh, Suma Saad, Gaurav Chaudhary, Gaurav Kumar Jain, Prashant Kesharwani, Farhan J. Ahmad
Various pharmacokinetic and pharmacodynamic drug interactions with Cannabis sativa might exist; still, there is a paucity of available literature. Cannabis has the same constitution as tobacco smoke, but quantitatively higher concentrations of polyaromatic hydrocarbons make it a carcinogenic agent [206]. Symptoms like chronic bronchitis-wheezing, cough, and phlegm have been reported in cannabis users. It increases the development of cancer risk, especially in adults below the age of 60 years [207,208]. One of the cannabinoids, specifically Δ9-THC, was reported to increase anxiety, psychotic symptoms, heart rate, and blood pressure and alter perception [209]. Minimal data is available regarding its safety in children that restricts its pharmacokinetic profile [28]. It is also forbidden for lactating and pregnant women due to the unavailability of enough studies and the risk of cannabinoid consumption that may enter the placenta and harm the newly born child [19]. Moreover, when cannabinoid is given in hepatic impairment patients, proper care should be taken because of the accumulation risk. Caution should be taken while other drugs administered with these inducers/inhibitors of CYP3A4 or CYP2C19 can decrease/increase its plasmatic concentration [19,210].
Safety and tolerability of nabiximols oromucosal spray: a review of more than 15 years” accumulated evidence from clinical trials
Published in Expert Review of Neurotherapeutics, 2021
José María Prieto González, Carlos Vila Silván
Although the potential therapeutic and medicinal properties of Cannabis sativa plant compounds have been known for centuries, scientific progress has been hindered by national laws restricting their use. Over the past three decades, however, investigation into the role of the endocannabinoid system in regulating many body functions has led to a dramatic shift in attitudes. As of 2021, several cannabis- or cannabinoid-based medicines are available for clinical use. Nabiximols (Sativex) oromucosal spray, which contains a balanced ratio of THC and CBD, is approved widely as add-on therapy for treatment-resistant MS spasticity [2] and, in Israel, as adjunctive treatment for neuropathic pain in MS patients [6]. In the US, the synthetic THC analogues nabilone (Cesamet®) and dronabinol (Syndros®, Marinol®) are indicated for treatment of chemotherapy-induced nausea and vomiting [60,61]. Dronabinol is also approved to treat anorexia associated with weight loss in patients with AIDS [61]. Most recently, a CBD oral solution (Epidiolex®, Epidyolex®) was approved in the US and EU for adjunctive therapy of seizures associated with Dravet syndrome or Lennox-Gastaut syndrome in patients aged ≥2 years [62]. Given the ever-expanding volume of literature on cannabis and cannabinoids in medical databases, product approvals in other indications might be anticipated in coming years.
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