This activity describes cannabinoid toxicity and highlights the role of the interprofessional team in its management. A full battery of oral reproductive and developmental studies has been conducted with purified CBD. In an embryo-foetal development study in Wistar rats, litter loss was noted at the highest applied dose of 250 mg/kg. In a prenatal and postnatal development study (referred to in 56) rat exposure to the highest doses (150 and 200 mg/kg/ day) affected reproductive organs (smaller testes in males, reduced fertility index in females). A high dose of 125 mg/ kg also reduced foetal body weight in New Zealand white rabbit, which was related to maternal toxicity.
This HBGV could be exceeded by the CBD dosages in some of the food supplements. The systematic search identified 28 independent randomized double-blind placebo-controlled clinical trials (Fig. 1), comprising data from a total of 1589 participants. Ten studies were excluded from further analysis because they were only reported in abstracts, posters or secondary descriptions from the grey literature. A further five were excluded because they did not report data on withdrawal or adverse events in a systematic way. The remaining 13 trials included a total of 822 participants and reported 266 different adverse outcomes, of which 33 provided sufficient data for meta-analysis (i.e., at least eight events across arms across studies per outcome) (Table 1).
Continuing Education Activity
In mice, THC produced thyroid follicular cell adenoma (a common benign neoplasm of the thyroid) in both sexes, but the effect was not dose-dependent, as the hyperplasia was increased compared to control at all doses and in both sexes. The one in beagle dogs (0.5, 1.0, 2.0 mg/kg/day) was planned to last one year but was terminated after seven months due to high mortality. Most deaths were preceded by convulsions, and toxicity was attributed to accumulation of carbinol metabolites in the brain over time. In contrast to dogs, nabilone chronic toxicity was minimal in rhesus monkeys receiving doses of up to 2.0 mg/kg/day for one year. Transient periods of anorexia, emesis, and ataxia were observed only at the highest dose.
The developmental toxicity in rabbits occurred at maternal plasma concentration similar to human at therapeutic doses (referred to in 56). No adequate data are available on pregnancy outcome in women exposed to CBD. CBD absorption increases is cannabidiol addictive three times with a high-fat meal and six times with new oral delivery system for lipophilic active compounds (61, 62). Its high estimated volume of distribution (18,800—30,959 L) indicates accumulation of CBD in body fat (63).
6. Respiratory Effects
Following 90 days of oral CBD ( mg/kg/day), liver and kidney weights in rhesus monkeys were 13-56% greater than controls, without morphological changes in the organs . In a study on the efficacy of CBD in schizophrenia, there was a low incidence (≥4%) of mild AEs including somnolence and insomnia, with a frequency similar to that found in placebo . Relevant studies reporting CBD’s AEs or toxicity were identified from PubMed, Cochrane Central, and EMBASE through January 2019. Studies defining CBD’s beneficial effects were included to provide balance in estimating risk/benefit. Call your healthcare provider if you have had severe vomiting for a day or more. This copyrighted material is provided by Natural Medicines Comprehensive Database Consumer Version.
Transformation of CBD may also occur in acidified plasma samples, heating at 175°C for 30 min, or during pyrolysis gas chromatography
, but not during vaping or smoking of low-THC cannabis products
. Chronic users may experience paranoia, panic disorder, fear, or dysphoria. These psychiatric effects may be less likely to occur with strains that contain higher concentrations of CBD. Large doses of THC may produce confusion, amnesia, delusions, hallucinations, anxiety, and agitation. Short-term memory is impaired even after small doses in both naive and experienced users. The deficits appear to be in acquisition of memory, which may result from an attentional deficit, combined with the inability to filter out irrelevant information and the intrusion of extraneous thoughts.
6. CBD Neuroprotection
The absorption kinetics of cannabinoids and THC depends on the exposure route, with inhalation reaching peak serum concentrations in less than thirty minutes, and ingestion peaking in concentration at around 2 to 4 hours (or longer) after consumption. Duration of https://ecosoberhouse.com/ toxicity secondary to inhalation and ingestion lasts approximately 2 to 6 hours and 8 to 12 hours, respectively. THC’s volume of distribution is approximately 3 liters per kilogram, and after exposure eventually collects in fat due to its high lipid solubility.
CBD AEs in humans listed in the Epidiolex® FDA approval notification  and in Epidiolex® prescription information  include decreased appetite, diarrhea, nausea, vomiting, and abdominal pain. CBD AEs in humans presented in the Epidiolex® FDA approval notification  and Epidiolex® prescription information  include transaminase elevation (especially with concomitant valproate). Epidiolex® can also cause liver injury, usually mild, but more severe injury with related symptoms such as jaundice can occur although rarely.