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Cannabis & Autoimmune Disorders

Explore the link between cannabis and autoimmune disorders, traditional treatments, endocannabinoid system, and cannabis strategies for MS and arthritis. Learn about cannabis dosage forms and getting your cannabis card.

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Cannabis & Autoimmune Disorders

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  1. Cannabis & Autoimmune Disorders Dr. Nick Salamie PharmD, RPh

  2. Autoimmune Disorders

  3. Symptoms

  4. Traditional Treatments • NSAIDs • Aleve • Advil • Immunosuppressant Drugs • Corticosteroids • Janus kinase inhibitors • Calcineurin inhibitors • mTOR inhibitors • IMDH inhibitors • Biologics • Monoclonal antibodies

  5. Endocannabinoid System • Complex Regulatory System • Regulates Immune Response • CB1 and CB2 Receptors • Immune Cells Express Both • Endocannabinoid and Phytocannabinoids • Immunosuppressive Properties • Cell death • Inhibition of Cell Growth • Inhibition of signaling and regulatory proteins • Inhibition of white blood cell attraction • THC modulates T-helper cells

  6. Multiple Sclerosis • Cannabis useful for symptom relief • Spasticity • Pain • Sleep • May reduce progression in early MS • Cannabis Strategies • Day: CBD/THC • Night: THC • Inhalation, Oral and Sublingual • Dosing based on patients cannabis experience • Advanced Consideration: Beta-Caryophyllene

  7. Rheumatoid Arthritis • Symptom Relief • Pain • Fatigue • Mood • Inflammation • THC • CBD • THCa • CBC • Beta-Caryophyllene This Photo by Unknown Author is licensed under CC BY-NC-ND

  8. First PDI Visit • Goals • Increase Quality of Life • Drug Interactions • Assess Patients Cannabis Experience • No or little cannabis experience • Intermediate cannabis experience • Advanced Cannabis Experience • Tapering Strategy if Necessary • Product selection and initial strategy • Minimum Effective Dose • Follow Up

  9. Dosage Forms • Inhalation • Combustion • Vaporization • Ingestible • Edibles • Oils (RSO) • Tablets/Capsules • Sublingual/Buccal/Oromucosal • Topical • Transdermal

  10. Cannabis Oils/RSOs • Best medical dosage form • Whole Plant/Full Spectrum Extract/Herbal Shotgun • Varying Cannabinoid Profiles • Different CBD:THC ratios • Acidic Cannabinoids: THCa, CBDa, CBGa • “Varin” Cannabinoids: THCV, CBDV • Less abundant Cannabinoids: CBN, CBG, CBC • Terpenes Captured • Beta-Caryophyllene

  11. Getting Your Cannabis Card • Formal Diagnosis of 1 of the 41 qualifying conditions • Completion of Physician Written Certification Form by a Licensed Physician • Fingerprint/Background Check • Completion of Online Registration and and Payment • Provisional Registration

  12. Resources • “Autoimmune Diseases: Types, Symptoms, Causes, Diagnosis & More.” Healthline, Healthline Media, www.healthline.com/health/autoimmune-disorders#common-autoimmune-diseases. • Backes, Michael, et al. Cannabis Pharmacy: the Practical Guide to Medical Marijuana. Black Dog & Leventhal Publishers, 2017. • “Health: Autoimmune Disorders and Cannabis.” Performance by Michele Ross, Green Flower Media, www.green-flower.com/episodes/504/autoimmune-disorders-and-cannabis. • “Immunosuppressant Drugs: A Complete Overview.” Healthline, Healthline Media, www.healthline.com/health/immunosuppressant-drugs. • Russo, Ethan B., and Jahan Marcu. “Cannabis Pharmacology: The Usual Suspects and a Few Promising Leads.” Cannabinoid Pharmacology Advances in Pharmacology, 2017, pp. 67–134., doi:10.1016/bs.apha.2017.03.004.

  13. Questions

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