Terapijski potencijal medicinske konoplje

Cilj istraživanja Cilj ovog specijalističkog rada je pregled podataka o glavnim farmakološki aktivnim sastavnicama vrste Cannabis sativa L. te provedenim kliničkim studijama na kojima se temelji njena medicinska uporaba. Materijal i metode Istraživanje u okviru ovog rada je teorijskog karaktera i uključuje pregled dostupne znanstvene i stručne literature o predloženoj temi. U pretraživanju su korištene relevantne elektronske mrežne stranice te bibliografske baze podataka kao što su: Current Contents, ScienceDirect, Scopus, PubMed, Medline i Cocharen Library. Rezultati Do danas je iz medicinske konoplje (Cannabis sativa L.) izolirano nekoliko stotina različitih sastavnica, među kojima i 104 kanabinoida. Najvažniji i najpoznatiji kanabinoid je delta-9-tetrahidrokanabinol (THC), zbog čijeg se psihoaktivnog djelovanja konoplja svrstava u opojne droge. Znanstveno je dokazano da kanabinoidi uglavnom djeluju preko dva tipa endokanabinoidnih receptora u središnjem živčanom sustavu (CB1) i imunosnim stanicama (CB2). Kliničke studije podupiru liječenje spasticiteta oboljelih od multiple skleroze, mučnine i povraćanja te boli u onkoloških bolesnika, kaheksije/anoreksije u HV/AIDS bolesnika te kod Dravetovog sindroma u djece. Zaključci Primjena medicinske konoplje u praksi odnosi se isključivo na simptomatsko liječenje kao dodana terapija. Liječenje se sastoji od faze individualne titracije doze (uz nadzor nad bolesnikom) i faze održavanja. Pored očekivanog terapijskog djelovanja, važno je sagledati i neželjene učinke koji se mogu pojaviti pri primjeni medicinske konoplje.Objectives The aim of this work was to review the data on the main pharmacologically active constituents of Cannabis sativa L. and on the conducted clinical studies on which its medical use is based. Material and methods Research in this paper is a theoretical one and includes a detailed overview of the available professional and scientific data on the topic. Relevant websites and bibliographic database such as Current Contents, ScienceDirect, Scopus, PubMed, Medline and Cocharen Library are searched. Results To date, several hundred different components have been isolated from medical cannabis (Cannabis sativa L.), including 104 cannabinoids. The principle active constituent is delta-9-tetrahydrocannabinol (THC) because of which psychoactive effect cannabis is classified as narcotic drugs. Scientific evidence demonstrates that cannabinoids act mainly through two types of cannabinoid receptors in the central nervous system (CB1) and immune cells (CB2). Clinical studies support the use of medical cannabis for treatment of spasticity in multiple sclerosis, nausea, vomiting and pain in oncology patients, anorexia associated with weight loss in patients with AIDS as well as Dravet syndrome in children. Conclusion The medical use of cannabis refers exclusively to symptomatic treatment as an add-on therapy. The treatment consists of the individual dose titration phase (under the supervision of the patient) and the maintenance phase. In addition to the expected therapeutic effect of cannabis, it is important to consider the adverse effects that may occur