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药用大麻——潜在的药物相互作用

Medicinal Cannabis-Potential Drug Interactions.

作者信息

Alsherbiny Muhammad A, Li Chun Guang

机构信息

NICM Health Research Institute, Western Sydney University, Westmead, NSW 2145, Australia.

Department of Pharmacognosy, Faculty of Pharmacy, Cairo University, Cairo 11562, Egypt.

出版信息

Medicines (Basel). 2018 Dec 23;6(1):3. doi: 10.3390/medicines6010003.

Abstract

The endocannabinoids system (ECS) has garnered considerable interest as a potential therapeutic target in various carcinomas and cancer-related conditions alongside neurodegenerative diseases. Cannabinoids are implemented in several physiological processes such as appetite stimulation, energy balance, pain modulation and the control of chemotherapy-induced nausea and vomiting (CINV). However, pharmacokinetics and pharmacodynamics interactions could be perceived in drug combinations, so in this short review we tried to shed light on the potential drug interactions of medicinal cannabis. Hitherto, few data have been provided to the healthcare practitioners about the drug⁻drug interactions of cannabinoids with other prescription medications. In general, cannabinoids are usually well tolerated, but bidirectional effects may be expected with concomitant administered agents via affected membrane transporters (Glycoprotein p, breast cancer resistance proteins, and multidrug resistance proteins) and metabolizing enzymes (Cytochrome P450 and UDP-glucuronosyltransferases). Caution should be undertaken to closely monitor the responses of cannabis users with certain drugs to guard their safety, especially for the elderly and people with chronic diseases or kidney and liver conditions.

摘要

内源性大麻素系统(ECS)作为各种癌症、癌症相关病症以及神经退行性疾病的潜在治疗靶点,已引起了广泛关注。大麻素参与多种生理过程,如刺激食欲、能量平衡、疼痛调节以及控制化疗引起的恶心和呕吐(CINV)。然而,药物组合中可能会出现药代动力学和药效学相互作用,因此在这篇简短的综述中,我们试图阐明药用大麻潜在的药物相互作用。迄今为止,向医疗从业者提供的关于大麻素与其他处方药之间药物相互作用的数据很少。一般来说,大麻素通常耐受性良好,但通过受影响的膜转运蛋白(糖蛋白p、乳腺癌耐药蛋白和多药耐药蛋白)和代谢酶(细胞色素P450和尿苷二磷酸葡萄糖醛酸转移酶)与同时服用的药物可能会产生双向效应。应谨慎密切监测大麻使用者与某些药物同时使用时的反应,以保障他们的安全,尤其是老年人以及患有慢性疾病或肾脏和肝脏疾病的人。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b38b/6473892/b0f41c854711/medicines-06-00003-g001.jpg

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