Pregled interakcij med kanabinoidi in zdravilnimi učinkovinami, zavedenih v podatkovnih bazah Lexicomp in PubMed

Korpar, Nina (author), Peterlin Mašič, Lucija (mentor), Kerec Kos, Mojca (comentor)

Pri sočasni uporabi THC in/ali CBD z ostalimi zdravilnimi učinkovinami lahko prihaja do medsebojnega delovanja oziroma interakcij. Interakcije med kanabinoidi in zdravilnimi učinkovinami so kompleksne in še ne povsem natančno raziskane. Namen magistrske naloge je identificirati interakcije med THC oz. CBD in zdravilnimi učinkovinami. Naš cilj je predstaviti farmakodinamične in farmakokinetične mehanizme teh interakcij po anatomsko-terapevtsko-kemični klasifikaciji zdravilnih učinkovin ter možnosti ukrepanja. Pregled interakcij med THC oziroma CBD in zdravilnimi učinkovinami smo opravili s pomočjo spletnih podatkovnih baz Lexicomp in PubMed. Iskanje člankov v bazi PubMed je potekalo z naslednjim iskalnim profilom: «(thc OR cbd OR cannabinoids OR cannabis) AND drugs AND interactions« in omejitvami: članki objavljeni v angleškem jeziku, članki objavljeni v obdobju 2015-2020, raziskave na ljudeh. Literaturo smo izbrali glede na v naprej določene vključitvene in izključitvene kriterije. S podatkovno bazo Lexicomp smo identificirali 541 potencialnih interakcij med THC oz. CBD in zdravilnimi učinkovinami. Med identificiranimi interakcijami je bilo največ interakcij tipa C in le tri interakcije tipa D. Interakcij tipa X nismo identificirali pri nobenem kanabinoidu. Od vseh zdravilnih učinkovin, ki vstopajo v interakcije s THC oz. CBD jih največ spada v skupino N po anatomsko-terapevtsko-kemični klasifikaciji. V pregled literature smo vključili 16 člankov. Le-ti v večini obravnavajo interakcije med CBD in antiepileptiki ter THC in zaviralci centralnega živčnega sistema. Do farmakokinetičnih interakcij pride zaradi vpliva na metabolične encime ali prenašalne proteine, kjer se spremeni farmakokinetika kanabinoidov oziroma zdravilnih učinkovin. Pri farmakodinamičnih interakcijah THC največkrat ojača zaviralno delovanje zdravilnih učinkovin, ki delujejo na centralni živčni sistem. S poznavanjem mehanizmov interakcij lahko prispevamo k preprečevanju oziroma zmanjšanju števila potencialnih interakcij. Uporaba podatkovne baze Lexicomp je uporabna za pridobitev informacij o potencialnih interakcijah, za končno odločitev pred intervencijo pa je potrebno kritično ovrednotenje podatkov ter pri slabše utemeljenih interakcijah dodatno preverjanje literature.

• Language: Slovenian
• Keywords: kanabinoidi, THC, CBD, interakcije med kanabinoidi in zdravilnimi učinkovinami
• Work type: Master's thesis/paper
• Organization: FFA - Faculty of Pharmacy
• Year: 2021
• PID: 20.500.12556/RUL-127743
• Publication date in RUL: 22.06.2021

Secondary language

• Language: English
• Title: A review of interactions between cannabinoids and drugs listed in Lexicomp and PubMed databases

Abstract

Interactions between cannabinoids and drugs may occur with the concomitant use of THC and/or CBD and other drugs. Interactions between cannabinoids and drugs are complex and have not been fully investigated yet. The purpose of this thesis is to identify interactions between cannabinoids, more precisely THC and CBD, and drugs. The aim of the thesis is to present the pharmacokinetic and pharmacodynamic mechanisms of these interactions according to the anatomical-therapeutic-chemical classification of drugs and to suggest course of action. A review of interactions between THC or CBD and drugs was performed by using two online databases: Lexicomp and PubMed. The search for articles in the PubMed database was performed with the following search profile: «(thc OR cbd OR cannabinoids OR cannabis) AND drugs AND interactions« and limits: published in the period of 2015 – 2020, English language, humans. The literature was selected according to the predetermined inclusion and exclusion criteria. We identified 541 potential interactions between THC or CBD and drugs in the Lexicomp database. Most of the identified interactions were type C and only three of them were type D. We did not identify any type X interaction. Of all the drugs that interact with THC or CBD most of them belong to the group N according to the anatomical-therapeutic-chemical classification. We included 16 articles in the literature review. Most of them discuss the interactions between CBD and antiepileptics and THC and central nervous system depressants. Pharmacokinetic interactions occur due to effects on metabolic enzymes or transport proteins where the pharmacokinetic of cannabinoids or drugs is altered. In pharmacodynamic interactions, THC most often potentiate the inhibitory effect of drugs acting on the central nervous system. By knowing the mechanism of interactions, we can contribute to the prevention or reduction of the number of potential interactions. The use of the Lexicomp database makes sense to obtain information about potential interactions but for the final decision before an intervention, a critical evaluation of interactions is needed and additional literature review in the case of less well-founded interactions.

• Keywords: cannabinoids, THC, CBD, interactions between cannabinoids and drugs