Cannabis and Cannabinoids in Pain Relief

Cannabis is a term that describes products derived from the Indian hemp, Cannabis sativa. It has its origins probably in India but now grows all over the world. The chemical compounds responsible for intoxication and medicinal effects are found mainly in a sticky golden resin exuded from the flowers of the female plants and surrounding leaves. Cannabis sativa contains a wide range of different chemicals including a family of compounds called “cannabinoids”. Of the cannabinoids delta-9 tetrahydrocannabinol (THC) is probably the main compound responsible for the psychotropic activities. Cannabis has been used as a medicine for thousands of years and is mentioned in a Chinese herbal dating back to 2700 BC. There are records of ’its medicinal use in Egyptian papyri of the sixteenth century BC. Much later, the plant is mentioned in Assyrian texts and in Greek and Roman sources as a medicinal agent. Early Experiences in the 19th Century Cannabis Tincture was used in the nineteenth century as an analgesic, as well as numerous other conditions and was considered milder and less dangerous than opium. W.B.O’Shaughnessy was the first of the western physicians to take an interest in cannabis as a medicine on account Read more […]

Nabilone — Clinical Experience at the James Paget Hospital

The dose per capsule is 1 mg but we found that this could be excessive for some patients. Therefore, some were started at 0.25 mg by opening the capsule and dividing the resultant powder into four. The initial time for nabilone use has been at night to reduce the potential discomfort of any side effects. Once the patient’s confidence has been developed, the dosage has been increased where appropriate. Those patients who have benefited from nabilone have been through a period of discontinuation to help evaluate the benefits of this drug. The age range of the 43 patients who have used nabilone is from 25–82 years with 75% between the ages of 30 and 50. More women than men were treated, mainly reflecting a large sex difference in the group with multiple sclerosis. The diagnoses of the patients were categorised into 6 groups as the most convenient method of presenting the information from such an heterogeneous group. No attempt has been made to do anything more than describe the effects of using nabilone on each individual patient and thereby evaluate whether it might be of value in pain control. Multiple Sclerosis Multiple Sclerosis is characterised by widespread and varied damage to the central nervous Read more […]

Pharmacology of Poppy Alkaloids: Minor Opium Alkaloids

The pharmacology and biology of minor opium alkaloids have been surveyed previously in two comprehensive reviews (). Thebaine The pharmacology of thebaine was summarized by Reynolds and Randall in 1957 and studied comprehensively by a WHO Advisory Group in 1980. The pharmacological actions of thebaine in various isolated organs have been studied. Thebaine can induce a temporary decrease in blood pressure in anaesthetized dogs and this depressor effect showed a marked tachyphylaxis. In isolated guinea pig atrium, thebaine decreased the heart rate and contractions depending on the concentration. In isolated rabbit ileum it decreased the peristaltic movement and contractions (). The predominant effect of thebaine is stimulation of the central nervous system. In the mouse, rabbit, cat and dog increases in motor activity and reflex excitability were observed at doses around 2-10mg/kg s.c. or i.m. The Straub-tail response was noted only occasionally. The effects of thebaine on body temperature and respiration have also been studied. Convulsions were observed in almost all species of animals including the frog, pigeon, mouse, guinea pig, cat and dog. Transient tremors, restlessness and convulsions were observed in the Read more […]

Specific Medicinal Uses of Cannabis

The historical and contemporary, medicinal uses of cannabis have been reviewed on several occasions. Perhaps the earliest published report to contain at least some objectivity on the subject was that of O’Shaughnessy (1842), an Irish surgeon, working in India, who described the analgesic, anticonvulsant and muscle relaxant properties of the drug. This report triggered the appearance of over 100 publications on the medicinal use of cannabis in American and European medical journals over the next 60 years. One such use was to treat nausea and vomiting; but it was not until the advent of potent cancer chemotherapeutic drugs that the antiemetic properties of cannabis became more widely investigated and then employed. One can argue that the available clinical evidence of efficacy is stronger here than for any other application and that proponents of its use are most likely to be successful in arguing that cannabis should be re-scheduled (to permit its use as a medicine) because it has a “currently accepted medical use”. Specific Medicinal Uses of Cannabis: Use as an Antiemetic Specific Medicinal Uses of Cannabis: Glaucoma Specific Medicinal Uses of Cannabis: Multiple Sclerosis Spastic Conditions A discussion Read more […]

Specific Medicinal Uses of Cannabis: Anticonvulsant Activity

As early as 1890, the use of cannabis was advocated for the suppression of convulsions in man. While there are some reports of the effects of smoking cannabis in this area, most effort has focused on synthetic cannabinoid derivatives. Cannabis Two reports indicate that regular cannabis smoking contributes to better control of seizures in epileptic patients whose disease is refractory to conventional therapy. These studies were not controlled and contained few patients. THC There have been no reports of the use of THC in epileptics; this compound has induced or exacerbated seizure activity in animal studies. Cannabidiol (CBD) Carlini and Cunha added CBD, 200–300 mg daily, to the anticonvulsant regime of eight patients with generalised secondary seizures, refractory to antiepileptic drugs. Over the 5-month observation period, improvement was noted in seven. Very similar results were reported in an earlier trial by Karler and Turkanis. In a placebo controlled study in patients with grand mal seizures, CBD produced improvement in seizure control in 7 patients, three of these showing great improvement. One patient showed some improvement on placebo however. Summarising, there seems to be little to recommend the Read more […]

Scarlet Wisteria Tree, Red Wisteria, Daun Turi

Sesbania grandiflora Pers. (Leguminosae) Sesbania grandiflora Pers. is a tree that can grow to 8-10 m in height. The compound leaves are about 30 cm long with 12 to 20 pairs of rounded, narrow, oblong leaflets, 3-4 cm by 1 cm. Flowers are 5-10 cm by 3 cm, in pale pink, red, purple or white. The pods are 25-50 cm, slender, and cylindrical with many light brown to red brown seeds. Origin Native to Malesia and cultivated in the tropics. Phytoconstituents Grandiflorol, (+)-leucocyanidin, oleanolic acid, lutein, beta-carotene, violaxanthin, neoxanthin, zeaxanthin and others. Traditional Medicinal Uses In the Philippines, the plant is used for its hypotensive properties. It is used in Indian folk medicine for the treatment of liver disorders. The juice of the leaves and flowers are popularly used for nasal catarrh and headache when taken as snuff. Various leaf preparations are used to treat epileptic fits. Applied externally for treatment of leprous eruptions. A poultice of the leaves is used for bruises. The leaf juice is mixed with honey for congenital bronchitis or cold in babies. Pharmacological Activities Antibacterial, Anticonvulsant, Anti-inflammatory, Anxiolytic, Depressant, Diuretic, Hepatoprotective, Hypoglycaemic, Read more […]

Anxiety Disorders: Supplements With Possible Efficacy

In addition to supplements discussed above, a few other compounds may also have some efficacy in treating symptoms of anxiety. However, since the data that supports the use of the following supplements is extremely limited, clinicians should proceed with caution, and consider the use of the compounds discussed in this section as experimental. St. John’s Wort As described in site, St. John’s Wort (Hypericum perforatum) is an herb that exists in many species throughout the world, and it is widely used as an antidepressant. It is available in a variety of preparations, including capsules, liquid, oils, and raw herb to be brewed as tea. St. John’s Wort contains a plethora of active ingredients, including flavonoids, naphthodianthrones, phloroglucinols, phenolic acids, terpenes, and xanthones. These exert a variety of psychoactive effects, and several of these are described below. Of all herbal supplements, St. John’s Wort is the one that has been researched most extensively and there is strong support for its efficacy in reducing depressive symptoms. The use of St. John’s Wort as an anxiolytic is more recent, but a few studies suggest that is may be effective. Davidson and Connor (2001) reported case studies of patients Read more […]

Kava Kava (Piper methysticum)

Kava Kava: Medical Uses Kava kava is used to improve mental function and for anxiety disorders, hot flashes, and anxiety and mild depression associated with menopause. Historical Uses Kava comes from a Greek word meaning “intoxicating.” The herb has been used in Polynesian countries to make a ceremonial drink. Growth This tropical, perennial shrub is a member of the pepper family and is native to Oceania. Part Used • Root Major Chemical Compound • Kavalactones Kava Kava: Clinical Uses Kava kava is used to improve mental function and for nonpsychotic anxiety disorders, hot flashes, and anxiety and mild depression associated with menopause. It is approved by the German Commission E for “anxiety, stress, and restlessness”. Mechanism of Action Kava kava has sedative, analgesic, anticonvulsant, and muscle relaxant effects and acts on the limbic system. Its action is different from that of aspirin, morphine, and benzo-diazepines. Little information is currently available on kavalactones. For anxiety: Standardized extract: 70 mg kavalactones two to three times daily. Capsules or tablets: 400 to 500 mg up to six times daily. Tincture (1:2): 15 to 30 drops up to three times daily. Tincture drops Read more […]

Nelumbo nucifera

Nelumbo nucifera Gaertn. (Nymphaeaceae) Sacred Lotus, East Indian Lotus, Oriental Lotus Nelumbo nucifera Gaertn. is an aquatic plant that grows in shallow waters. Leaves are green, round, 30-60 cm across and with long petiole. Flowers are pink, white or red, 10-30 cm and solitary. Fruits are non-edible and non-fleshy. Origin Native to tropical and temperate Asia, Australia and Eastern Europe. Phytoconstituents Nuciferin, nornuciferin, nelumboroside A & B, nelumstemine, dotriacontane, ricinoleic, roemerin, liensinine, neferine, lotusine, liriodenine, asimilobin, pronuciferine and others. Traditional Medicinal Uses The leaves are used to treat sunstroke, diarrhoea, dysentery, fever, dizziness and vomiting of blood. The plant is used as an antidote for mushroom poisoning and for smallpox. In Ayurveda, the plant is used to treat cholera, diarrhoea, worm infestation, vomiting, exhaustion and intermittent fever. The fruits are used in decoction for agitation, fever, heart and haematemesis while the stamens are used to “purify the heart, permeate the kidneys, strengthen virility, to blacken the hair, for haemoptysis and spermatorrhoea”. They are also used to treat premature ejaculation, as astringent for bleeding, Read more […]

Herbs For Behavioral Conditions

Most behavioral conditions in small animals arise from stress and anxiety. These include aggression, inappropriate urination, lick granuloma, separation anxiety, and storm and other phobias. Herbal medicines provide a number of interesting alternatives to conventional veterinary mood-modifying drugs. The approach depends upon the nature of the behavioral disturbance and the severity and duration of the condition. Other perpetuating factors and health issues such as pain or endocrine disturbances, which can contribute to aggression and anxiety, must be considered. Nervines are the traditional class of herbs employed for emotional conditions in humans, and they have applications in veterinary medicine, too. Nervines can be further classified. Nervine relaxants have anxiolytic, sedating, or hypnotic activity. They include herbs such as Valerian, Hops, Lavender, Lemon balm, and Passion flower, and may be prescribed for anxiety, hyperactivity, restlessness, and irritability. Nervine stimulants are perhaps the least used group in veterinary medicine, but they may be beneficial for a depressed or hypoactive nervous system. They may be used extensively by veterinary staff in the form of tea and coffee. Others, such as Kola Read more […]