Perioperative care of cannabis users: A comprehensive review of pharmacological and anesthetic considerations

Villalobos, Marco Echeverria; Todeschini, Alexandre Bossi; Stoicea, Nicoleta; Fiorda-Diaz, Juan; Weaver, Tristan; Bergese, Sergio D.

doi:10.1016/j.jclinane.2019.03.011

Cited by 77 publications

(129 citation statements)

References 126 publications

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“…Although the focus of this article was to identify and describe specific ∆ 9 -THC and CBD cannabinoid drug-drug interactions, there are physiologic effects that can be attributed to cannabinoid use that may impact the cardiovascular, cerebrovascular, respiratory, temperature, and coagulation systems for the hospitalized and surgical patients [44]. The patient’s current use of cannabinoids (whether it be prescription, OTC, and/or illicit) should be taken into consideration when medically managing a patient during a hospital stay or when selecting a medication to treat pain, nausea, and/or vomiting in the outpatient setting [45, 46].…”

Section: Discussionmentioning

confidence: 99%

“…The patient’s current use of cannabinoids (whether it be prescription, OTC, and/or illicit) should be taken into consideration when medically managing a patient during a hospital stay or when selecting a medication to treat pain, nausea, and/or vomiting in the outpatient setting [45, 46]. The withdrawal of a cannabinoid (more specific to heavy recreational cannabis use) may precipitate the cannabis withdrawal syndrome [44]. In addition, there have been reports of patients who regularly use recreational cannabis and then require higher doses of propofol for sedation [47].…”

Section: Discussionmentioning

confidence: 99%

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Delta-9-Tetrahydrocannabinol and Cannabidiol Drug-Drug Interactions

Kocis

Vrana

2020

Med Cannabis Cannabinoids

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Although prescribing information (PI) is often the initial source of information when identifying potential drug-drug interactions, it may only provide a limited number of exemplars or only reference a class of medications without providing any specific medication examples. In the case of medical cannabis and medicinal cannabinoids, this is further complicated by the fact that the increased therapeutic use of marijuana extracts and cannabidiol oil will not have regulatory agency approved PI. The objective of this study was to provide a detailed and comprehensive drug-drug interaction list that is aligned with cannabinoid manufacturer PI. The cannabinoid drug-drug interaction information is listed in this article and online supplementary material as a PRECIPI-TANT (cannabinoid) medication that either INHIBITS/INDUC-ES the metabolism or competes for the same SUBSTRATE target (metabolic enzyme) of an OBJECT (OTHER) medication. In addition to a comprehensive list of drug-drug interactions , we also provide a list of 57 prescription medications displaying a narrow therapeutic index that are potentially impacted by concomitant cannabinoid use (whether through prescription use of cannabinoid medications or therapeutic/recreational use of cannabis and its extracts).

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Delta-9-Tetrahydrocannabinol and Cannabidiol Drug-Drug Interactions

Kocis

Vrana

2020

Med Cannabis Cannabinoids

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“…Majority of the systemic effects of cannabis are due to tetrahydrocannabinol (THC) which is the most psychotropic cannabinoid with abuse potential. [ 1 2 ] Healthcare workers stand a higher risk for contracting infections while handling these cases. Viral markers should be tested and universal precautions taken.…”

Section: Casementioning

confidence: 99%

“…Cannabis is used as a recreational drug and commonly known as ganja, joint or weed. [ 1 2 ] In India, possession or smoking of cannabis is an illegal and punishable offence. Perioperative arrhythmias in the patients with cannabis addiction are a rare entity and may pose a diagnostic dilemma if the history of its abuse has been concealed.…”

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confidence: 99%

Persistent intraoperative arrhythmias due to cannabis: Report of two cases

2020

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“…However, the mechanism is still unknown. Thus, it is urgent for us to detect the mechanism of arrhythmia after anesthesia during operation [4].…”

Section: Introductionmentioning

confidence: 99%

A new heterometallic MOF with 1D nano-sized channels for cyanosilylation reaction and prevention effect against arrhythmia by reducing the sympathetic excitability

Ding

Zhang

et al. 2020

Journal of Experimental Nanoscience

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In this work, by appealing to a heterometallic cluster approach, a new highly porous metal-organic framework (MOF) formulated as f(Me 2 NH 2)[Ni 3 K 2 (TZIA) 3 (H 2 O) 3 ]Á(DMF) 4 g n (1) has been fabricated by a solvothermal reaction of a bifunctional organic ligand 5-(1 H-tetrazol-5-yl)isophthalic acid (H 3 TZIA) with the Ni(II) and K(I) salts in water and DMF mixed solvents. The resulting activated 1a has been explored in detail for BET analysis to probe its porosity. The removal of water molecule at the aim of generating 1a makes K þ ion become a heterogeneous catalyst of size-selective with high efficiency for solvent-free cyanosilylation of acetaldehyde under mild conditions. Furthermore, the prevention effect of the compound on the arrhythmia occurrences after anesthesia during operation was evaluated. The arrhythmia incidence and abnormal blood pressure was calculated and measured for the detection of compound prevention ability. Besides, the Norepinephrine (NE) and Adrenaline (A) released by the cardiomyocytes were measured by the ELISA kit.

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Perioperative care of cannabis users: A comprehensive review of pharmacological and anesthetic considerations

Cited by 77 publications

References 126 publications

Delta-9-Tetrahydrocannabinol and Cannabidiol Drug-Drug Interactions

Delta-9-Tetrahydrocannabinol and Cannabidiol Drug-Drug Interactions

Persistent intraoperative arrhythmias due to cannabis: Report of two cases

A new heterometallic MOF with 1D nano-sized channels for cyanosilylation reaction and prevention effect against arrhythmia by reducing the sympathetic excitability

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