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Medical marijuana patient counseling points for health care professionals based on trends in the medical uses, efficacy, and adverse effects of cannabis-based pharmaceutical drugs.

Abstract

The purpose of this report is to present a review of the medical uses, efficacy, and adverse effects of the three approved cannabis-based medications and ingested marijuana. A literature review was conducted utilizing key search terms: dronabinol, nabilone, nabiximols, cannabis, marijuana, smoke, efficacy, toxicity, cancer, multiple sclerosis, nausea, vomiting, appetite, pain, glaucoma, and side effects. Abstracts of the included literature were reviewed, analyzed, and organized to identify the strength of evidence in medical use, efficacy, and adverse effects of the approved cannabis-based medications and medical marijuana. A total of 68 abstracts were included for review. Dronabinol's (Marinol) most common medical uses include weight gain, chemotherapy-induced nausea and vomiting (CINV), and neuropathic pain. Nabiximol's (Sativex) most common medical uses include spasticity in multiple sclerosis (MS) and neuropathic pain. Nabilone's (Cesamet) most common medical uses include CINV and neuropathic pain. Smoked marijuana's most common medical uses include neuropathic pain and glaucoma. Orally ingested marijuana's most common medical uses include improving sleep, reducing neuropathic pain, and seizure control in MS. In general, all of these agents share similar medical uses. The reported adverse effects of the three cannabis-based medications and marijuana show a major trend in central nervous system (CNS)-related adverse effects along with cardiovascular and respiratory related adverse effects. Marijuana shares similar medical uses with the approved cannabis-based medications dronabinol (Marinol), nabiximols (Sativex), and nabilone (Cesamet), but the efficacy of marijuana for these medical uses has not been fully determined due to limited and conflicting literature. Medical marijuana also has similar adverse effects as the FDA-approved cannabis-based medications mainly consisting of CNS related adverse effects but also including cardiovascular and respiratory related adverse effects. Finally, insufficient higher-order evidence to support the widespread use of medical marijuana was found, but a limited amount of moderate-level evidence supports its use in pain and seizure management.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    School of Pharmacy and Health Professions, University of Maryland Eastern Shore, Princess Anne, MD 21853, USA. Electronic address: jparmar@umes.edu.

    ,

    School of Pharmacy and Health Professions, University of Maryland Eastern Shore, Princess Anne, MD 21853, USA.

    School of Pharmacy and Health Professions, University of Maryland Eastern Shore, Princess Anne, MD 21853, USA.

    Source

    MeSH

    Counseling
    Dronabinol
    Health Personnel
    Humans
    Marijuana Smoking
    Medical Marijuana
    Patient Education as Topic

    Pub Type(s)

    Journal Article
    Review

    Language

    eng

    PubMed ID

    26443472

    Citation

    Parmar, Jayesh R., et al. "Medical Marijuana Patient Counseling Points for Health Care Professionals Based On Trends in the Medical Uses, Efficacy, and Adverse Effects of Cannabis-based Pharmaceutical Drugs." Research in Social & Administrative Pharmacy : RSAP, vol. 12, no. 4, 2016, pp. 638-54.
    Parmar JR, Forrest BD, Freeman RA. Medical marijuana patient counseling points for health care professionals based on trends in the medical uses, efficacy, and adverse effects of cannabis-based pharmaceutical drugs. Res Social Adm Pharm. 2016;12(4):638-54.
    Parmar, J. R., Forrest, B. D., & Freeman, R. A. (2016). Medical marijuana patient counseling points for health care professionals based on trends in the medical uses, efficacy, and adverse effects of cannabis-based pharmaceutical drugs. Research in Social & Administrative Pharmacy : RSAP, 12(4), pp. 638-54. doi:10.1016/j.sapharm.2015.09.002.
    Parmar JR, Forrest BD, Freeman RA. Medical Marijuana Patient Counseling Points for Health Care Professionals Based On Trends in the Medical Uses, Efficacy, and Adverse Effects of Cannabis-based Pharmaceutical Drugs. Res Social Adm Pharm. 2016;12(4):638-54. PubMed PMID: 26443472.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Medical marijuana patient counseling points for health care professionals based on trends in the medical uses, efficacy, and adverse effects of cannabis-based pharmaceutical drugs. AU - Parmar,Jayesh R, AU - Forrest,Benjamin D, AU - Freeman,Robert A, Y1 - 2015/09/16/ PY - 2015/08/28/received PY - 2015/09/03/revised PY - 2015/09/04/accepted PY - 2015/10/8/entrez PY - 2015/10/8/pubmed PY - 2017/7/18/medline KW - Appetite KW - Cancer KW - Cannabis KW - Dronabinol KW - Efficacy KW - Glaucoma KW - Marijuana KW - Multiple sclerosis KW - Nabilone KW - Nabiximols KW - Nausea KW - Pain KW - Side effects KW - Smoke KW - Toxicity KW - Vomiting SP - 638 EP - 54 JF - Research in social & administrative pharmacy : RSAP JO - Res Social Adm Pharm VL - 12 IS - 4 N2 - The purpose of this report is to present a review of the medical uses, efficacy, and adverse effects of the three approved cannabis-based medications and ingested marijuana. A literature review was conducted utilizing key search terms: dronabinol, nabilone, nabiximols, cannabis, marijuana, smoke, efficacy, toxicity, cancer, multiple sclerosis, nausea, vomiting, appetite, pain, glaucoma, and side effects. Abstracts of the included literature were reviewed, analyzed, and organized to identify the strength of evidence in medical use, efficacy, and adverse effects of the approved cannabis-based medications and medical marijuana. A total of 68 abstracts were included for review. Dronabinol's (Marinol) most common medical uses include weight gain, chemotherapy-induced nausea and vomiting (CINV), and neuropathic pain. Nabiximol's (Sativex) most common medical uses include spasticity in multiple sclerosis (MS) and neuropathic pain. Nabilone's (Cesamet) most common medical uses include CINV and neuropathic pain. Smoked marijuana's most common medical uses include neuropathic pain and glaucoma. Orally ingested marijuana's most common medical uses include improving sleep, reducing neuropathic pain, and seizure control in MS. In general, all of these agents share similar medical uses. The reported adverse effects of the three cannabis-based medications and marijuana show a major trend in central nervous system (CNS)-related adverse effects along with cardiovascular and respiratory related adverse effects. Marijuana shares similar medical uses with the approved cannabis-based medications dronabinol (Marinol), nabiximols (Sativex), and nabilone (Cesamet), but the efficacy of marijuana for these medical uses has not been fully determined due to limited and conflicting literature. Medical marijuana also has similar adverse effects as the FDA-approved cannabis-based medications mainly consisting of CNS related adverse effects but also including cardiovascular and respiratory related adverse effects. Finally, insufficient higher-order evidence to support the widespread use of medical marijuana was found, but a limited amount of moderate-level evidence supports its use in pain and seizure management. SN - 1934-8150 UR - https://www.unboundmedicine.com/medline/citation/26443472/Medical_marijuana_patient_counseling_points_for_health_care_professionals_based_on_trends_in_the_medical_uses_efficacy_and_adverse_effects_of_cannabis_based_pharmaceutical_drugs_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1551-7411(15)00170-9 DB - PRIME DP - Unbound Medicine ER -