Center for Drug Evaluation & Safety, University of Florida, Gainesville, Florida, USA.
Consortium for Medical Marijuana Clinical Outcomes Research, University of Florida, Gainesville, Florida, USA.
J Clin Pharmacol. 2021 Aug;61 Suppl 2:S37-S52. doi: 10.1002/jcph.1871.
The purpose of this narrative review is to describe the current use environment of both natural and synthetic cannabinoids while providing context for cannabinoid chemistry and pharmacology. In addition to a long history of recreational and nonmedical use, natural cannabinoids are increasingly used as prescription products, through medical cannabis programs, and as consumer health products. Despite anecdotal safety evidence, cannabis and cannabinoids are pharmacologically complex and pose risks for adverse drug events and drug-drug interactions. Synthetic cannabinoids, particularly agonists of cannabinoid receptors, are more potent than natural cannabinoids and can lead to more severe reactions and medical emergencies. This review provides a summary of approved uses and an overview of mechanisms of action for adverse drug events with natural and synthetic cannabinoids. Clinical considerations for special populations that may be at heightened risk for drug-drug interactions and adverse drug events while using natural or synthetic cannabinoids are examined, and recommendations are provided.
本文的目的是描述天然和合成大麻素的当前使用环境，并为大麻素的化学和药理学提供背景知识。除了长期以来的娱乐和非医疗用途外，天然大麻素越来越多地被用作处方药，通过医疗大麻计划和消费者保健产品。尽管有传闻安全性证据，但大麻和大麻素在药理学上非常复杂，存在药物不良事件和药物相互作用的风险。合成大麻素，特别是大麻素受体激动剂，比天然大麻素更有效，可能导致更严重的反应和医疗紧急情况。本文综述了天然和合成大麻素的批准用途，并概述了药物不良事件的作用机制。本文还研究了使用天然或合成大麻素时可能面临药物相互作用和药物不良事件风险增加的特殊人群的临床注意事项，并提供了建议。
