Mahvan Tracy D, Hilaire Michelle L, Mann Allison, Brown Antoinette, Linn Becky, Gardner Taylor, Lai Beryen
Consult Pharm. 2017 Jun 1;32(6):341-351. doi: 10.4140/TCP.n.2017.341.
This article reviews the literature on the use of marijuana in the elderly. Pharmacists play an important role in the management of medications including drug use of potentially illegal drugs, including marijuana. The use of both recreational and medical marijuana has grown exponentially in the general population, including in older adults. As of 2017, marijuana for medical use is legal in 26 states and the District of Columbia.
PubMed and Internet search using the following terms: marijuana, cannabis, delta-9-tetrhydrocannabinol (THC), cannabidiol, cannabinoid, elderly, geriatric, and pharmacology. Findings are based on data collected from older adults (65 years of age and older) through August 2016.
Because of the lack of research and funding, reputable literature on the impact of marijuana on older adults is scarce. The available evidence suggests that elderly individuals should be cautious when consuming marijuana, especially those who have certain comorbid conditions.
The geriatric population has a higher likelihood of having multiple comorbidities and is subject to polypharmacy. Marijuana use, medicinal or recreational, complicates the picture with additive central nervous system side effects.
This article reviews the growing information on marijuana use and discusses issues to consider and cautions in usage that can apply to day-to-day clinical practice and geriatric care. The role of the pharmacist in educating patients, caregivers, and health care providers is expanding with the growing number of states that have legalized medical marijuana (26 states and the District of Columbia, as of 2017). Important education points including drug-drug interactions, drug-disease interactions, and signs and symptoms of acute overdose should be considered.
With this review, pharmacists will be informed on recommendations on the use of marijuana in the older adult. Monitoring of therapy, as well as adverse effects, will be reviewed, including some legal issues and challenges.
本文回顾了关于老年人使用大麻的文献。药剂师在药物管理中发挥着重要作用，包括对潜在非法药物（如大麻）的使用管理。在普通人群中，包括老年人在内，娱乐性和医用大麻的使用量都呈指数级增长。截至2017年，医用大麻在26个州和哥伦比亚特区是合法的。
使用以下术语在PubMed和互联网上进行搜索：大麻、大麻属植物、δ-9-四氢大麻酚（THC）、大麻二酚、大麻素、老年人、老年医学、药理学。研究结果基于截至2016年8月从65岁及以上老年人中收集的数据。
由于缺乏研究和资金，关于大麻对老年人影响的可靠文献稀缺。现有证据表明，老年人在使用大麻时应谨慎，尤其是那些患有某些合并症的人。
老年人群发生多种合并症的可能性更高，且常接受多种药物治疗。使用大麻，无论是用于医疗还是娱乐，都会因中枢神经系统副作用叠加而使情况变得复杂。
本文回顾了关于大麻使用的越来越多的信息，并讨论了在日常临床实践和老年护理中可应用的使用时需考虑的问题和注意事项。随着越来越多的州（截至2017年有26个州和哥伦比亚特区）将医用大麻合法化，药剂师在教育患者、护理人员和医疗服务提供者方面的作用正在扩大。应考虑重要的教育要点，包括药物相互作用、药物与疾病相互作用以及急性过量的体征和症状。
通过本次综述，药剂师将了解关于老年人使用大麻的建议。将回顾治疗监测以及不良反应，包括一些法律问题和挑战。
