Marinol drug class
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Marinol Drug Class: An Overview
Introduction to Marinol (Dronabinol)
Marinol, also known by its generic name dronabinol, is a synthetic form of delta-9-tetrahydrocannabinol (THC), the primary psychoactive component found in marijuana. It is classified as a Schedule III controlled substance and is primarily used for medical purposes 27.
Medical Uses of Marinol
Appetite Stimulation and Nausea Control
Marinol is approved for two main medical uses: stimulating appetite in patients with AIDS-related anorexia and controlling nausea and vomiting in cancer patients undergoing chemotherapy who have not responded to conventional anti-emetic therapies 27. These applications leverage the drug's ability to mimic the effects of natural THC, providing relief from severe symptoms associated with these conditions.
Expanded Medical Applications
Beyond its approved uses, Marinol has been explored for other medical applications based on anecdotal reports and clinical studies. These include potential benefits in managing neuropathic pain and other conditions, although these uses are not yet officially sanctioned 25.
Mechanism of Action
Interaction with Cannabinoid Receptors
Marinol works by activating cannabinoid receptors in the body, specifically CB1 and CB2 receptors. These receptors are part of the endocannabinoid system, which plays a role in regulating various physiological processes, including appetite, pain sensation, and mood 78. By binding to these receptors, Marinol can help alleviate symptoms such as nausea and stimulate appetite.
Drug Testing and Marinol
Differentiating Marinol from Marijuana Use
One challenge with Marinol is distinguishing its use from illicit marijuana use in drug testing. Both natural and synthetic THC are identical, making it difficult to determine the source of THC metabolites in urine tests. However, the presence of delta9-tetrahydrocannabivarin (THCV) and its metabolites can serve as markers to differentiate between marijuana use and Marinol ingestion, as THCV is found in natural cannabis but not in Marinol 13.
Adverse Effects and Precautions
Common Side Effects
Marinol shares many of the adverse effects associated with natural marijuana, primarily affecting the central nervous system. These can include euphoria, dizziness, and in severe cases, seizures and coma 56. Cardiovascular and respiratory side effects are also reported, necessitating careful monitoring of patients 5.
Severe Reactions
In rare instances, Marinol can induce severe conditions such as warm autoimmune hemolytic anemia, which requires immediate medical intervention. This highlights the importance of exercising caution when prescribing Marinol, especially in patients with complex medical histories 6.
Conclusion
Marinol (dronabinol) is a valuable medication in the management of AIDS-related anorexia and chemotherapy-induced nausea and vomiting. While it offers significant therapeutic benefits, it also poses challenges in drug testing and potential adverse effects. Ongoing research and careful clinical use are essential to maximize its benefits while minimizing risks.
Sources and full results
Most relevant research papers on this topic
Drug testing in the workplace: could a positive test for one of the mandated drugs be for reasons other than illicit use of the drug?
A positive drug test in the workplace may result from circumstances other than illicit use of the drug, such as passive inhalation, unknowing oral ingestion, and the use of Marinol.
Literature ReviewDronabinol
Dronabinol's medical uses have expanded beyond its approved indications, with potential benefits for appetite stimulation in AIDS-related anorexia and treatment of chemotherapy-induced nausea and vomiting in patients who fail to respond to conventional anti-emetic therapies.
Literature ReviewDelta9-tetrahydrocannabivarin as a marker for the ingestion of marijuana versus Marinol: results of a clinical study.
THCV-COOH is detected in urine specimens only after ingestion of marijuana, not after ingestion of Marinol (oral or smoking).
RCTMarinomycins A-D, antitumor-antibiotics of a new structure class from a marine actinomycete of the recently discovered genus "marinispora".
Marinomycins A-D show significant antimicrobial activities against drug-resistant bacteria and selective cancer cell cytotoxicities against six melanoma cell lines, highlighting the potential of marine actinomycetes for drug discovery.
Highly CitedMedical marijuana patient counseling points for health care professionals based on trends in the medical uses, efficacy, and adverse effects of cannabis-based pharmaceutical drugs.
Medical marijuana shares similar medical uses with approved cannabis-based medications, but its efficacy for these uses remains inconclusive due to limited and conflicting evidence.
Systematic Review
Rigorous JournalMarinol-induced warm autoimmune hemolytic anemia.
Marinol, a marijuana product, can cause severe warm autoimmune hemolysis in cancer patients, requiring immediate discontinuation and steroid therapy with blood transfusion.
Case ReportRigorous JournalLinking in Vitro Lipolysis and Microsomal Metabolism for the Quantitative Prediction of Oral Bioavailability of BCS II Drugs Administered in Lipidic Formulations.
The novel in vitro lipolysis/metabolism approach accurately predicts the oral bioavailability of lipophilic drugs administered in lipidic formulations, with strong correlation between observed and predicted values.
In Vitro StudyEmerging strategies for exploiting cannabinoid receptor agonists as medicines
Cannabinoid receptor agonists show potential in treating various diseases, but more therapeutic targets and improved efficacy are needed to overcome challenges in efficacy and safety.
Highly CitedThe emerging role of cannabinoid neuromodulators in symptom management
Cannabinoid neuromodulators, such as nabilone and dronabinol, show potential in managing symptoms beyond chemotherapy-induced nausea and vomiting in cancer patients.
Rigorous JournalTHE EFFECTIVENESS OF CANNABINOIDS FOR THE TREATMENT OF CACHEXIA IN HIV-POSITIVE PATIENTS
Cannabinoids, such as dronabinol, can positively impact appetite and weight gain in HIV-positive patients, but their effectiveness compared to megestrol acetate remains unclear.
Systematic Review