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CNS stimulants, such as cocaine, amphetamines, and cannabinoids, have varying structures and mechanisms of action that lead to different therapeutic effects and side effects. Cocaine, with its molecular formula C17H21NO4, is a tropane alkaloid and a tertiary amino compound. It has two chemical forms: the hydrochloride salt and the "freebase." The former is in powder form, while the latter involves removing the hydrochloride salt to create a form that can be smoked. Cocaine exerts its...
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In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
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In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses...
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Updated: Jan 30, 2026

Tobacco Hornworm as an Insect Model System for Cannabinoid Pre-clinical Studies
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Cannabinoid toxicity in pediatrics.

Eike Blohm1, Peter Sell2, Mark Neavyn3

  • 1Department of Surgery, Larner College of Medicine.

Current Opinion in Pediatrics
|January 30, 2019
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Summary

Legalized cannabis presents new challenges for pediatric care. High-concentration products cause acute toxicity, while chronic use may lead to neurocognitive issues and cannabinoid hyperemesis syndrome in children.

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Area of Science:

  • Pediatric Emergency Medicine
  • Cannabinoid Toxicology
  • Adolescent Health

Background:

  • Legalized cannabis has increased accessibility for pediatric patients.
  • Healthcare providers face challenges in managing pediatric cannabinoid exposure and toxicity.
  • Reviewing recent literature on THC is crucial for clinical practice.

Purpose of the Study:

  • To summarize recent literature on tetrahydrocannabinol (THC) pharmacokinetics and pharmacodynamics.
  • To review the developmental impacts of cannabis in pediatric populations.
  • To outline acute and chronic toxicity presentations in children and adolescents.

Main Methods:

  • Literature review of recent studies on cannabis in pediatrics.
  • Synthesis of information on THC absorption, metabolism, and effects.
  • Analysis of clinical presentations and management strategies.

Main Results:

  • High-concentration cannabis products (edibles, resins, vaping fluid) are associated with acute pediatric toxicity, including sedation and respiratory depression.
  • Chronic cannabis use in adolescents can result in neurocognitive changes and cannabinoid hyperemesis syndrome.
  • Accidental exposure in young children is a significant concern.

Conclusions:

  • Clinicians must counsel pediatric patients and caregivers on reducing accidental cannabis exposure, especially from high-potency products.
  • Consideration of chronic cannabis exposure is essential when evaluating symptoms like persistent vomiting or academic decline.
  • Enhanced awareness and clinical guidance are needed to address the evolving landscape of pediatric cannabis use.