Terminology and facts about Cannabis relevant to toxicology
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| What parts of Cannabis sativa have the highest levels of the primary psychoactive substance? | flowering tops > leaves > stems > seeds > roots
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| What are the metabolites of Delta-9-THC? | 11-hydroxy-THC (THC-OH, active metabolite)
11-nor-9-carboxy-THC (THC-COOH, inactive metabolite)
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| Describe the metabolism of Delta-9-THC. | Delta-9-THC-->THC-OH-->THC-COOH
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| What are the physiological effects of Cannabis? | Red eye, increased heart rate, dry mouth, increased appetite, vasodilation, eyelid tremors, body tremors
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| Describe the duration of effects of Cannabis | Peak effects occur at 10-30 minutes.
Average duration of euphoria is 2-3 hours.
Baseline return is 3-5 hours.
Residual effects can last up to 24 hours.
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| What is counterclockwise hysteresis? | A delay between effects and plasma concentrations. A drug crosses the blood-brain barrier quickly (fast onset), but it takes about 45 minutes for the drug concentration to reach equilibrium in blood and tissues.
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| Describe the cannabinoid receptors. | CB1 and CB2 are G protein coupled receptors.
Sense molecule outside cell-->active signal transduction-->cellular response.
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| What is the endogenous ligand for the cannabinoid receptors? | anandamide
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| What are the half lives of THC and THC-COOH? | THC: 24 hours
THC-COOH: 20-57 hours (acute user), 3-13 days (chronic user)
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| What is the plasma:whole blood ratio for THC? | 10 ng/mL whole blood = 20 ng/mL plasma
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| What are the limitations of the combined model estimation of last consumption? | Postmortem cases due to PMR.
Ultra-chronic users.
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| What is the Daldrup Intoxication Factor? | Molar ratio: ([THC]+[THC-OH])/[THC-COOH].
The ratio correlates to the feeling of intoxication.
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| What is the Cannabis equivalent to the ethanol per se law? | 7-10 ng/mL THC (plasma) produces the same risk of MVA as 0.05 BAC.
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| What whole blood concentrations of THC are typically seen at ADFS? | THC: 2.7 ng/mL
THC-COOH: 22 ng/mL
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| What effects does abstinence have on the residual effects of Cannabis use? | Cannabis abstinence improves divided attention impairment in chronic users. However, after 3 weeks, impairment can still be observed in comparison to control groups.
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| What is the main task involved in driving that is affected by Cannabis use? | Vigilance.
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| How long can you store samples containing THC? | Can be stored in blood for 3-6 months at -20C.
Degrades in heat, light, and air.
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| What are the hallmark signs of Cannabis use? | Difficulty following instructions.
Short term memory and attention deficits.
Issues with vigilance.
Time-space distortion.
Body and eyelid tremors.
Increased reaction time.
Psychomotor and cognitive impairment.
Motor skill and tracking decrements.
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