Write a qualitative review paper on Marijuana following the APA format with the following outline

REQUIRED CONTENT (Using APA format)

a. THE PHARMACOLOGY OF MARIJUANA:

Content must include, at a minimum, the topics below.

i. A description of the endocannabinoid system

ii. A description of the components of marijuana, including the major cannabinoids and terpenes

iii. the basic pharmacology of the major cannabinoids

b. CONTRAINDICATIONS: ABSOLUTE AND RELATIVE

Content must address, at a minimum, the topics below.

i. History of psychotic illness or a family history of a first degree relative with schizophrenia

ii. Women should not consume during pregnancy or while breastfeeding except on the advice of the certifying practitioner, and in the case of breastfeeding mothers, including the infant’s pediatrician

iii. Any other relevant contraindications such as but not limited to: cardiovascular, liver or kidney disease

c. SIDE EFFECTS:

Content must address, at a minimum, the side effects listed below and include factors which may influence the side effect profile (dosage form, route of administration, cannabinoid profile, patient comorbidities, or any other factors).

i. Dysphoria; sometimes severe

ii. Nausea at high doses

iii. Dizziness

iv. Ataxia

v. Dry mouth

vi. Bronchitis

d. ADVERSE REACTIONS:

Content must address, at a minimum, the adverse reactions listed below and include factors which may influence adverse reactions (dosage form, route of administration, cannabinoid profile, patient comorbidities, or any other factors).

i. Cardiovascular

Tachycardia, palpitations, hypertension

ii. Respiratory

Coughing, wheezing, sputum production

iii. Central Nervous System

Lethargy, sedation, dizziness, slowed reaction time

iv. Psychological

Impaired coordination, memory formation, recollection, focus

v. Visual Disturbances

vi. Cannabis Hyperemesis Syndrome

e. DRUG INTERACTIONS: i. Substrates

ii. Inhibitors

iii. Inducers

f. OVERDOSE PREVENTION:

At a minimum, the topics listed below must be addressed.

i. Onset of action with various dosage forms and when to repeat a dosage

ii. Maintain medical marijuana products in the packaging in which they were dispensed

iii. Store medical marijuana products securely and keep out of reach of children

iv. Summarize risk factors and data related to overdose and consequences of an overdose, including with high tetrahydrocannabinol (THC) versus high cannabidiol (CBD) content strains

v. Provide information regarding median lethal dose

g. ROUTES OF ADMINISTRATION AND DOSING: i. Describe the administration methods authorized in New York State. 1. Metered liquid or oil preparations

2. Solid and semisolid preparations (e.g. capsules, chewable and effervescent tablets, lozenges)

3. Metered ground plant preparations

4. Topical forms and transdermal patches

5. Medical cannabis may not be incorporated into food products by the registered organization, unless approved by the commissioner

6. Smoking is not an approved route of administration

ii. Describe dosing strategies in cannabis naïve vs experienced cannabis users.

iii. Dosing must include differences between dosage forms and routes of administration in dosing and effects, including onset and duration of action, and frequency of dosing.

iv. At a minimum, dosing for the administration methods listed below must be addressed.

1. Vaporization

2. Oromucosal preparations (e.g. tinctures, sprays)

3. Oral Solid Dosage Forms (e.g. capsules, tablets)

4. Topical Preparations (e.g. creams, lotions, oils, patches, salves)

NOTE: Any content on dosing or administration methods that are prohibited in New York State must explicitly state that the administration method or form is prohibited in New York State.

h. RISKS AND BENEFITS:

Explain factors to consider when weighing risks of medical marijuana versus benefits of medical marijuana for a patient, including, but not limited to, the factors listed below.

i. Patient’s condition and comorbidities

ii. Patient’s age

iii. Co-administration of other drugs/medicine

i. WARNINGS AND PRECAUTIONS:

At a minimum, the warnings and precautions listed below must be addressed.

i. Medical marijuana may impair the ability to drive

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ii. KEEP MEDICAL MARIJUANA PRODUCTS AWAY FROM CHILDREN (unless medical marijuana product is being given to the child under a practitioner’s care)

iii. Keep medical marijuana products in the original packaging in which they are dispensed to the patient

j. ABUSE AND DEPENDENCE: i. Address Cannabis Use Disorder and provide information on where patients can go for help, including, but not limited to contact information for the Office of Alcoholism and Substance Use Disorder (OASAS) in New York State

ii. Describe physical dependence, addiction and tolerance with medical marijuana

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