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Natural and Synthetic Cannabinoids: Pharmacology, Uses, Adverse Drug Events, and Drug Interactions
Author(s) -
Brown Joshua D.,
Rivera Rivera Kevin J.,
Hernandez Leilanie Y. Crespo,
Doenges Matthew R.,
Auchey India,
Pham Thanh,
Goodin Amie J.
Publication year - 2021
Publication title -
the journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.92
H-Index - 116
eISSN - 1552-4604
pISSN - 0091-2700
DOI - 10.1002/jcph.1871
Subject(s) - synthetic cannabinoids , drug , pharmacology , context (archaeology) , cannabis , medicine , cannabinoid receptor , cannabinoid , recreational drug , adverse effect , clinical pharmacology , ecstasy , agonist , psychiatry , biology , receptor , paleontology
The purpose of this narrative review is to describe the current use environment of both natural and synthetic cannabinoids while providing context for cannabinoid chemistry and pharmacology. In addition to a long history of recreational and nonmedical use, natural cannabinoids are increasingly used as prescription products, through medical cannabis programs, and as consumer health products. Despite anecdotal safety evidence, cannabis and cannabinoids are pharmacologically complex and pose risks for adverse drug events and drug‐drug interactions. Synthetic cannabinoids, particularly agonists of cannabinoid receptors, are more potent than natural cannabinoids and can lead to more severe reactions and medical emergencies. This review provides a summary of approved uses and an overview of mechanisms of action for adverse drug events with natural and synthetic cannabinoids. Clinical considerations for special populations that may be at heightened risk for drug‐drug interactions and adverse drug events while using natural or synthetic cannabinoids are examined, and recommendations are provided.