HES

Q: Cannabinoids are? - Select one

A) Hydrophilic

B) Lipophilic

Answer: B

Cannabinoids accumulate in adipose tissues, including central and peripheral adipose tissues, due to their lipophilic nature.

Clinical significance: In patients who are long-term users of cannabinoids, when exposed to fasting, lipolysis occurs in the body, and degradation of cannabinoid into pro-emetic agents precipitates hyperemesis, leading to Cannabinoid Hyperemesis Syndrome (HES). Moreover, if the patient has genetic differences in his cytochrome P450 system, it causes the accumulation of cannabinoid metabolites, making HES worse/intense.

#toxicity

#drug-abuse

#GI

References:

1. Wightman RS, Metrik J, Lin TR, et al. Cannabis Use Patterns and Whole-Blood Cannabinoid Profiles of Emergency Department Patients With Suspected Cannabinoid Hyperemesis Syndrome. Ann Emerg Med 2023; 82:121.

2. Russo EB, Spooner C, May L, et al. Cannabinoid Hyperemesis Syndrome Survey and Genomic Investigation. Cannabis Cannabinoid Res 2022; 7:336.

3. Burillo-Putze G, Richards JR, Rodríguez-Jiménez C, Sanchez-Agüera A. Pharmacological management of cannabinoid hyperemesis syndrome: an update of the clinical literature. Expert Opin Pharmacother. 2022 Apr;23(6):693-702. doi: 10.1080/14656566.2022.2049237. Epub 2022 Mar 20. PMID: 35311429.