CANNABIS IN CANCER PAIN MANAGEMENT

Kanabinoidi, aktivni sastojci Cannabis sativa, oponašaju učinke endogenih kanabinoida (endokanabinoidi), aktivacijom specifičnih kanabinoidnih receptora, osobito CB1 dominantno smještenih u centralom živčanom sustavu i CB2 pretežito u stanicama uključenim u imunološku funkciju. Kanabinoidi su učinkoviti za liječenje boli kod odraslih, kemoterapijom inducirane mučnine i povraćanja i spasticiteta udruženog s multiplom sklerozom. Medicinski kanabis umanjuje kroničnu ili neuropatsku bol kod bolesnika s uznapredovalim karcinomom. Nedostatno liječenje kronične i neuropatske boli udružene s karcinomom ima negativne učinke na kvalitetu života bolesnika. Kod neuropatske boli i karcinomske boli medicinski kanabinoidi dolaze u obzir za bolesnike čije je stanje refraktorno na standardno liječenje. Medicinski kanabinoidi dodatak su drugim propisanim analgeticima. Potencijalnu štetu i korist treba razmotriti s bolesnikom.Cannabinoids, the active components of Cannabis sativa, mimic the effects of endogenous cannabinoids (endocannabinoids), activating specifi c cannabinoid receptors, particularly CB1 found predominantly in the central nervous system and CB2 found predominantly in the cells involved in immune function. Cannabinoids are effective in the treatment of pain in adults, chemotherapy-induced nausea and vomiting and spasticity associated with multiple sclerosis. In cancer patients, cannabis has a number of potential benefi ts, especially in the management of symptoms. Medical cannabis reduces chronic or neuropathic pain in advanced cancer patients. Insuffi cient management of cancer-associated chronic and neuropathic pain adversely affects patient quality of life. In neuropathic pain and cancer pain, medical cannabinoids should only be considered for patients whose conditions are refractory to standard therapies. Medical cannabinoids are adjuncts to other prescribed analgesics. The potential harms and benefi ts should be discussed with the patient