大麻使用和周期性吐综合征:公开辩论
Yassine Kilani1, Yazan Aljabiri2, Iqra Arshad3
1Department of Medicine, Lincoln Medical Center/Weill Cornell Medical College, New York, USA.
概括
在循环吐综合征 (CVS) 病例中使用大麻与更短的住院时间和更少的30天再入院有关. 这表明大麻在控制心血管神经系统症状方面可能发挥作用,或表明需要区分大麻超综合征 (CHS).
科学领域:
- 胃肠病学 胃肠病学
- 药理学 药理学是指药理学的学科.
- 卫生经济学 卫生经济学
背景情况:
- 循环吐综合征 (CVS) 给美国医疗保健系统带来了巨大的财务负担,原因是急诊室的频繁访问和住院治疗.
- 了解医院利用率和再接收率的预测因素对于管理CVS成本和患者结果至关重要.
研究的目的:
- 更新关于影响循环吐综合征 (CVS) 患者入院医院利用率和再入院率的因素的文献.
- 在CVS招生中分析大麻使用和医疗保健资源利用之间的关联.
主要方法:
- 在全国范围内对住院患者进行回顾性分析,首要诊断为CVS.
- 利用来自国家住院患者样本 (NIS) 和国家再接收数据库 (NRD) 的加权数据.
- 进行了多变量回归分析,以确定停留时间 (LOS) 和30天再录取的预测因素.
主要成果:
- 总共有35,055个初级CVS入学被确定在NIS和31,240在NRD.
- 6.4%的患者 (2012) 经历了30天的再入院.
- 大麻使用与减少LOS (aMD = -0.53天) 和30天再入院的几率较低 (aHR = 0.63) 有关.
结论:
- 在CVS入院中使用大麻与停留时间的减少和30天的再入院相关.
- 这些发现可能会受到大麻高缩综合征 (CHS) 住院治疗或大麻戒断对减轻症状的影响的影响.
- 建议将CHS的ICD-10编码转换为特定的代码,以便更好地区分CVS和CHS相关的入院.
相关概念视频
Chemotherapy-Induced Nausea and Vomiting: Cannabinoids
287
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.
Two synthetic agonists of THC,...
Two synthetic agonists of THC,...
287
Pathophysiology of Vomiting
510
Vomiting is a complex physiological response to expel harmful or irritating substances from the body. It's a defensive mechanism triggered by stimuli like poisons, microbial toxins, cytotoxic drugs, and mechanical abdominal distension. The process is centrally coordinated by the vomiting (or emetic) center located in the medulla of the brainstem. This area, rich in muscarinic M1, histamine H1, neurokinin 1 (NK1), and serotonin 5-HT3 receptors, coordinates the act of vomiting through...
510
CNS Stimulants: Cocaine, Amphetamines and Cannabinoids
207
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...
207
Chemotherapy-Induced Nausea and Vomiting: Neurokinin-1 Receptor Antagonists
170
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...
170
Chemotherapy-Induced Nausea and Vomiting: Dopamine Receptor Antagonists
305
Dopamine receptor antagonists, also known as antipsychotic agents, are critical in managing chemotherapy-induced vomiting. These antiemetic agents block dopamine receptors in the chemoreceptor trigger zone (CTZ), inhibiting signal transmission to the vomiting center. Antipsychotic agents encompass phenothiazines (PTZ), butyrophenones, benzamides, and thienobenzodiazepines (Zyprexa), which are utilized for their antiemetic and sedative properties.
Phenothiazines, such as prochlorperazine...
Phenothiazines, such as prochlorperazine...
305
Chemotherapy-Induced Nausea and Vomiting: 5-HT3 Receptor Antagonists
217
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,...
217


