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Chemotherapy-Induced Nausea and Vomiting: Cannabinoids01:21

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Tetrahydrocannabinol (THC) is a phytocannabinoid that primarily interacts with the CB1 receptor, a type of G protein-coupled receptor (GPCR) predominantly in and around the chemoreceptor trigger zone (CTZ) and emetic center. THC also blocks the serotonin receptor activity in the dorsal vagal complex (DVC) by inhibiting serotonin release. THC exerts its anti-emetic effects through these interactions, which are beneficial for patients undergoing chemotherapy.
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CNS Stimulants: Cocaine, Amphetamines and Cannabinoids01:24

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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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Neurokinin 1 (NK1) receptors are distributed across the GI tract, vagal afferents, and key CNS regions including the central vomiting center and chemoreceptor trigger zone (CTZ) Chemotherapy agents stimulate enterochromaffin cells in the gastrointestinal (GI) tract to release large amounts of substance P (SP). SP is a neuropeptide released by specific sensory nerves in response to many different stressors, including those in the GI mucosa affected by chemotherapy.  SP binds and activates...
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Allergic Drug Reactions01:27

Allergic Drug Reactions

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Allergic reactions related to drugs are hypersensitivity responses driven by the immune system and bear no connection to the drug's therapeutic action. While drugs in isolation do not trigger an immune response, they can interact with endogenous proteins to form antigens. These antigens stimulate lymphocytes to produce antibodies. IgE-type antibodies attach themselves to mast cells. Upon subsequent exposure to the same stimulus, the antigen-antibody interaction is initiated, unleashing...
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5-HT3 receptor antagonists, such as dolasetron, granisetron (Kytril), ondansetron (Zofran), and palonosetron (Axoli), are crucial in managing chemotherapy-induced nausea and vomiting (CINV) and postoperative nausea. These drugs selectively block 5-HT3 receptors in the visceral vagal and spinal afferent nerves, chemoreceptor trigger zone, and the vomiting center. They have a rapid onset of action and can be given as a single dose before chemotherapy. Ondansetron and granisetron, in particular,...
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In the intricate landscape of the gastric lumen, excessive acid secretion disrupts the natural defense mechanisms, weakening the mucus-bicarbonate barrier. This vulnerability allows pepsin to infiltrate epithelial cells, digesting mucosal proteins and triggering erosion, leading to ulcer formation.
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Weeding Out the Culprit: Cannabinoid-Associated Stevens-Johnson Syndrome.

Jessie Li1, Michael Miller1, Suha Abu Khalaf2

  • 1Medicine, University of Missouri, Columbia, USA.

Cureus
|June 26, 2023
PubMed
Summary

A rare case of Stevens-Johnson syndrome (SJS) was linked to cannabinoid use in a 32-year-old female. Prompt treatment led to full recovery, highlighting the need for awareness of drug-induced skin reactions.

Keywords:
cannabis useclinical case reportcutaneous adverse drug reactionstevens-johnson syndrome (sjs)toxic epidermal necrolysis (ten)

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Area of Science:

  • Dermatology
  • Toxicology
  • Pharmacology

Background:

  • Stevens-Johnson syndrome (SJS) is a severe mucocutaneous adverse drug reaction.
  • Recreational drug use is an under-recognized cause of SJS.
  • Cannabinoid use has not been widely associated with SJS.

Observation:

  • A 32-year-old female presented with a progressive, worsening rash.
  • Skin biopsy confirmed Stevens-Johnson syndrome.
  • Detailed history revealed recent recreational cannabinoid use.

Findings:

  • Cannabinoid-associated Stevens-Johnson syndrome was diagnosed.
  • The patient received symptomatic treatment including pain management, antihistamines, and topical steroids.
  • No complications were noted during or after treatment.

Implications:

  • This case expands the known spectrum of triggers for SJS.
  • Highlights the importance of thorough recreational drug history in diagnosing SJS.
  • Suggests a potential need for further research into cannabinoid-induced hypersensitivity reactions.