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 PRECIPITANT (cannabinoid) medication that either INHIBITS/INDUCES 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).

/pdf/delta-9-tetrahydrocannabinol-and-cannabidiol-drug-drug-276h4iln8x.pdf

Delta-9-Tetrahydrocannabinol and Cannabidiol Drug-Drug Interactions.

This paper attempts to examine and reflect on my experiences of being a beginning social worker and beginning teacher. I describe the similarities between the two processes. In many respects they were painful experiences, fraught with disappointments, frustrations, and, at times, loss, sadness, and anger. Yet, out of these painful experiences, there are many humorous events and many different, diverse, and interesting opportunities. All these experiences enriched my learning, and produce a worker and teacher who is able to draw on all these experiences for the benefit of his clients and students.

"What a long, strange trip it's been".

The usage and values of cannabis, or cannabis for medicinal purposes, have been recognised in history since ancient times. Evidence from clinical research demonstrated the therapeutic advantages of cannabis in an extensively wide area of medicinal aspects. Resultantly, many nations have decided to legalise the medicinal use of cannabis. Despite the recognition of medical cannabis internationally, Malaysia maintains the status quo of cannabis prohibition as a highly addictive drug with no medicinal value. The Malaysian government argues that the harmful effects of medical cannabis legalisation outweighs the benefits. Nevertheless, a lack of thematic review studies has been observed on the impact of medical cannabis legalisation. Therefore, this thematic review utilised the ATLAS.ti 9 software to synthesise literature from 2017 to 2021 to identify recent academic discussions on the impact of legalising medical cannabis. A keyword search and the screening process utilising Scopus and Web of Science (WoS) databases inclusion criteria yielded 718 peer-reviewed academic journals articles. Nonetheless, only 72 articles were selected for final evaluation following the exclusion and inclusion process. The thematic review of the 72 publications identified 19 preliminary codes on the impact of medical cannabis legalisation. The publications were grouped into five themes: (1) impact on health, (2) impact on policy, (3) impact on the society, (4) impact on health system and (5) impact on criminal activities. The findings will benefit future studies on implementing medical cannabis law (MCL) in Malaysia. However, this study is limited to Scopus and WoS databases. Furthermore, the impact of recreational cannabis legalisation is not included in this study. The findings may benefit future research on medical cannabis legalisation and the suitable regulatory framework of medical cannabis policy for Malaysia. 

Impact of medical cannabis legalisation: a thematic review

Objective: As health care providers, it is important to recognize the potential health issues associated with marijuana use and to educate patients appropriately. As with other types of medication, marijuana has drug interactions, side effects, and the potential for toxicity. In addition, as with other substances that are abused, marijuana has the potential for dependence and addiction. The expanding use of marijuana will increase the pharmacist's involvement with marijuana as part of a patient's regimen. The objective of this paper is to educate health care providers on potential counseling points for patients in regards to side effects, drug interactions and other potential adverse effects from marijuana use. Summary: Currently in the United States, 29 states (plus Washington D.C.) have passed laws allowing for the use of medical marijuana. The possession limit and form of marijuana varies by state. It is imperative that pharmacists understand the laws in their state and the overall effects of marijuana. Conclusion: The increased legalization will continue to expand marijuana's use among patients, necessitating health care providers to be well informed regarding marijuana's side effects, drug interactions, and addiction potential.

/pdf/the-impact-of-medical-marijuana-on-pharmacy-practice-jzowzkfofj.pdf

The Impact of Medical Marijuana on Pharmacy Practice

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The Impact of Medical Marijuana on Pharmacy Practice