title: Inhaled medicinal cannabis and the immunocompromised patient.
abstract: Medicinal cannabis is an invaluable adjunct therapy for pain relief, nausea, anorexia, and mood modification in cancer patients and is available as cookies or cakes, as sublingual drops, as a vaporized mist, or for smoking. However, as with every herb, various microorganisms are carried on its leaves and flowers which when inhaled could expose the user, in particular immunocompromised patients, to the risk of opportunistic lung infections, primarily from inhaled molds. The objective of this study was to identify the safest way of using medicinal cannabis in immunosuppressed patients by finding the optimal method of sterilization with minimal loss of activity of cannabis. We describe the results of culturing the cannabis herb, three methods of sterilization, and the measured loss of a main cannabinoid compound activity. Systematic sterilization of medicinal cannabis can eliminate the risk of fatal opportunistic infections associated with cannabis among patients at risk.
authors.affiliation: Department of Hematology, Shaare Zedek Medical Center, 12 Shmuel Biet St., 91031, Jerusalem, Israel, ruc@szmc.org.il.
authors.forename: Rosa
authors.initials: R
authors.lastname: Ruchlemer
authors.forename: Michal
authors.initials: M
authors.lastname: Amit-Kohn
authors.forename: David
authors.initials: D
authors.lastname: Raveh
authors.forename: Lumír
authors.initials: L
authors.lastname: Hanuš
mesh_terms: D000280:Administration, Inhalation; D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001228:Aspergillosis / Q000209:etiology / Q000276:immunology; D001230:Aspergillus / Q000302:isolation & purification; D002051:Burkitt Lymphoma / Q000188:drug therapy*; D002188:Cannabis / Q000382:microbiology; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D064086:Medical Marijuana / Q000008:administration & dosage* / Q000009:adverse effects*; D009325:Nausea / Q000139:chemically induced / Q000517:prevention & control*; D009894:Opportunistic Infections / Q000517:prevention & control; D059408:Pain Management / Q000009:adverse effects / Q000379:methods; D008517:Phytotherapy / Q000009:adverse effects / Q000379:methods; D013242:Sterilization / Q000379:methods; D014839:Vomiting / Q000139:chemically induced / Q000517:prevention & control*; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D064086:Medical Marijuana