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Zusammenfassung

Bei Tumorkranken stößt die Schmerztherapie mitMorphinpräparaten mitunter an ihre Grenzen. Unzureichende Analgesie oder stark beeinträchtigende Nebenwirkungen machen den Einsatz von adjuvanten Therapeutika erforderlich und werfen die Frage nach möglichen Alternativen auf. Eine potentielle „Option“, die in den letzten Jahren vermehrt in den Mittelpunkt des wissenschaftlichen, aber auch des öffentlichen Interesses gelangt ist, stellen Cannabis und seine Inhaltsstoffe dar. Cannabis enthält mehr als 600 definierte Substanzen, darunter alleine ein Gemisch aus ca. 63 verschiedenen psychotropen und nicht-psychotropen Cannabinoiden mit dem Hauptinhaltsstoff Δ9-Tetrahydrocannabinol (THC, Dronabinol). Weitere wichtige Inhaltsstoffe sind das Δ8-Tetrahydrocannabinol, Cannabidiol und Cannabinol.

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Literatur

  1. Abrams DI, Jay CA, Shade SB, Visozo H, Reda H, Press S, Kelly ME, Rowbotham MC, Petersen KL (2007) Cannabis in painful HIV-associated sensory neuropathy. Neurology 68: 515–521

    Article  PubMed  CAS  Google Scholar 

  2. Beal JA (1994) Appetite effect of dronabinol. J Clin Oncol 12: 1524–1525

    PubMed  CAS  Google Scholar 

  3. Baldwin GC, Tashkin DP, Buckley DM, Park AN, Dubinett SM, Roth MD (1997) Habitual smoking of marijuana and cocaine impairs alveolar macrophage function and cytokine production. J Respir Crit Care Med 156: 1606–1613

    Article  CAS  Google Scholar 

  4. Blake DR, Robson P, Ho M, Jubb RW, McCabe CS (2006) Preliminary assessment of the efficacy, tolerability and safety of a cannabis-based medicine (Sativex) in the treatment of pain caused by rheumatoid arthritis. Rheumatology 45(1):50–52

    Article  PubMed  CAS  Google Scholar 

  5. Buggy DJ, Toogood L, Maric S, Sharpe P, Lambert DG, Rowbotham DJ (2003) Lack of analgesic efficacy of oral delta-9-tetrahydrocannabinol in postoperative pain. Pain 106(1-2):169–172

    Article  PubMed  CAS  Google Scholar 

  6. Holdcroft A, Maze M, Dore C, Tebbs S, Thompson S (2006) A multicenter dose-escalation study of the analgesic and adverse effects of an oral cannabis extract (Cannador) for postoperative pain management. Anesthesiology 104(5):1040–1046

    Article  PubMed  CAS  Google Scholar 

  7. Jatoi A, Windschitl HE, Loprinzi CL, Sloan JA, Dakhil SR, Mailliard JA, Pundaleeka S, Kardinal CG, Fitch TR, Krook JE, Novotny PJ, Chistensen B (2002) Dronabinol versus megestrol acetate versus combination therapy for cancer-associated anorexia: a North Central Cancer Treatment Group study. J Clin Oncol 20: 567–573

    Article  PubMed  CAS  Google Scholar 

  8. Johnson JR, Burnell-Nugent M, Lossignol D, Ganae-Motan ED, Potts R, Fallon Marie T (2010) Multicenter, Double-Blind, Randomized, Placebo-Controlled, Parallel-Group Study of the Efficacy, Safety, and Tolerability of THC:CBD Extract and THC Extract in Patients with Intractable Cancer-Related Pain. J Pain Symptom Manage 39(2): 167–179

    Article  PubMed  Google Scholar 

  9. Marsicano G, Wotjak CT, Azad SC, Bisogno T, Rammes G, Cascio MG, Hermann H, Tang J, Hofmann C, Zieglgänsberger W, DiMarzo V, Lutz B (2002) The endogenous cannabinoid system controls extinction of aversive memories. Nature 418: 530–534

    Article  PubMed  CAS  Google Scholar 

  10. Kraft B, Frickey NA, Kaufmann RM, Reif M, Frey R, Gustorff B, Kress HG (2008) Lack of analgesia by oral standardized cannabis extract on acute inflammatory pain and hyperalgesia in volunteers. Anesthesiology 109(1):101–110

    Article  PubMed  Google Scholar 

  11. Mechoulam R, Hanu L (2001) The cannabinoids: an overview. Therapeutic implications in vomiting and nausea after cancer chemotherapy, in appetite promotion, in multiple sclerosis and in neuroprotection. Pain Res Manag 6: 67–73

    PubMed  CAS  Google Scholar 

  12. Meiri E, Jhangiani H, Vredenburgh JJ, Barbato LM, Carter FJ, Yang HM, Baranowski V (2007) Efficacy of dronabinol alone and in combination with odansetron versus ondansetron alone for delayed chemotherapy-induced nausea and vomiting. Curr Med Res Opin 23(3): 533–543

    Article  PubMed  CAS  Google Scholar 

  13. Naef M, Curatolo M, Petersen-Felix S, Arendt-Nielsen L, Zbinden A, Brenneisen R (2003) The analgesic effect of oral delta-9-tetrahydrocannabinol (THC), morphine and a THC-morphine combination in healthy subjects under experimental pain conditions. Pain 105 (1-2): 79–80

    Article  PubMed  CAS  Google Scholar 

  14. Narang S, Gibson D, Wasan AD, Ross EL, Michna E, Nedeljkovic SS, Jamison RN (2008) Efficacy of dronabinol as an adjuvant treatment for chronic pain patients on opioid therapy. J Pain (3): 254–264

    Google Scholar 

  15. Noyes R, Brunk SF, Avery DA, Canter AC (1975) The analgesic properties of delta-9 tetrahydrocannabinol and codeine. Clin Pharmacol Ther 18(1): 84–89

    PubMed  Google Scholar 

  16. Nurmikko TJ, Serpell MG, Hoggart B, Toomey PJ, Morlion BJ, Haines D (2007) Sativex successfully treats neuropathic pain characterised by allodynia: a randomised, double-blind, placebo-controlled clinical trial. Pain 133(1-3): 210–220

    Article  PubMed  CAS  Google Scholar 

  17. Parker LA, Kwiatkowska M, Mechoulam R (2006) Delta-9-tetrahydrocannabinol and cannabidiol, but not ondansetron, interfere with conditioned retching reactions elicited by a lithium-paired context in Suncus murinus: An animal model of anticipatory nausea and vomiting. Physiol Behav 87(1): 66–71

    Article  PubMed  CAS  Google Scholar 

  18. Radbruch L, Nauck F (2004) Cannabinoide in der Behandlung von Übelkeit und Erbrechen. Schmerz 18: 306–310

    PubMed  CAS  Google Scholar 

  19. Reynolds R (2002) Comparative efficacy of dronabinol and megestrol acetate. J Clin Oncol 20: 2912–2913

    PubMed  Google Scholar 

  20. Smith PF (2002) Cannabinoids in the treatment of pain and spasticity in multiple sclerosis. Curr Opin Investig Drugs 3: 859–864

    PubMed  CAS  Google Scholar 

  21. Svendsen KB, Jensen TS, Bach FW (2004) Does the cannabinoid dronabinol reduce central pain in multiple sclerosis? BMJ 329: 257–258

    Article  Google Scholar 

  22. Strasser F, Luftner D, Possinger K, Ernst G, Ruhstaller T, Meissner W, Ko YD, Schnelle M, Reif M, Cerny T (2006) Comparison of orally administered cannabis extract and delta-9-tetrahydrocannabinol in treating patients with cancer-related anorexia-cachexia syndrome: a multicenter, phase III, randomized, double-blind, placebo-controlled clinical from the Cannabis-In-Cachexia-Study-Group. J Clin Oncol 24(21): 3394–3400

    Article  PubMed  CAS  Google Scholar 

  23. Tashkin DP, Baldwin GC, Sarafian T, Dubinett S, Roth MD (2002) Respiratory and immunologic consequences of marijuana smoking. J Clin Pharmacol 42: 71–81

    Google Scholar 

  24. Timpone JG, Wright DJ, Li N, Egorin MJ, Enama ME, Mayers J, Galetto G (1997) The safety and pharmacokinetics of single-agent and combination therapy with megestrol acetate and dronabinol for the tratment of HIV wasting syndrome. Aids Res Human Retroviruses 13: 305–315

    Article  CAS  Google Scholar 

  25. Tramer MR, Carroll D, Campbell FA, Reynolds DJ, Moore RA, McQuay HJ (2001) Cannabinoids for control of chemotherapy induced nausea and vomiting: quantitative systematic review. BMJ 323: 16–21

    Article  PubMed  CAS  Google Scholar 

  26. Walker JM, Huang SM (2002) Cannabinoid analgesia. Phamacol Ther 95: 127–135

    Article  CAS  Google Scholar 

  27. Wallace M, Schulteis G, Atkinson HJ, Wolfson T, Lazzaretto MS, Bentlea H, Gouaux B, Abramson I (2007) Dose-dependent effects of smoked cannabis on capsaicin-induced pain and hyperalgesia in healthy volunteers. Anesthesiology 107: 785–789

    Article  PubMed  Google Scholar 

  28. Wilsey B, Marcotte T, Tsodikov A, Millman J, Bentley H, Gouaux B, Fishman S (2008) A randomized, placebo-controlled, crossover trial of cannabis cigarettes in neuropathic pain. J Pain 9(6): 506–521

    Article  PubMed  CAS  Google Scholar 

  29. Zajicek J, Fox P, Sanders H, Wright D, Vickery J, Nunn A, Thompson A (2003) Cannabinoids for treatment of spasticity and other symptoms related to multiple sclerosis (CAMS study): multicentre randomised placebo-controlled trial. Lancet 362: 1517–1526

    Article  PubMed  CAS  Google Scholar 

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Kress, H.G., Kraft, B. (2012). Cannabinoide in der Palliativmedizin. In: Bernatzky, G., Sittl, R., Likar, R. (eds) Schmerzbehandlung in der Palliativmedizin. Springer, Vienna. https://doi.org/10.1007/978-3-211-88877-3_13

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  • DOI: https://doi.org/10.1007/978-3-211-88877-3_13

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  • Print ISBN: 978-3-211-88876-6

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