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Dr Luis Otávio Caboclo, neurologista formado no Hospital das Clinicas da FMUSP, mestrado e doutorado pela Universidade de São Paulo, professor da Faculdade de Medicina Hospital Albert Einstein. Dr Marcelo De Lima Oliveira doutor pelo departamento de neurologia do Hospital das Clinicas da Faculdade de Medicina da USP Dr Luis Otavio Caboclo nesse podcast detalha as formas da planta Cannabis: para uso recreativo a planta tem altas concentrações de THC (cannabis sativa) e para uso medicinal a planta tem altas concentrações de CBD (canabbis sativa com muito canabidióde) e baixas concentrações de THC conhecida como cânhamo. Existem mais de 120 substancias (terrenos e flavonóides, entre outros) na planta cannabis sendo as duas principais CBD e THC. A cannabis é estudada há mais de 2000 mil anos antes de Cristo para tratar certas condições clinicas na China. Em Bagdá (Mesopotâmia) no século VII um médico usou a Canabbis para fins medicinas. No século XIX um médico inglês usou a Cannabis Índica na Índia para tratar uma forma de epilepsia grave (síndrome de West). Esse médico levou esse conhecimento para o Reino Unido que incluiu a Cannabis na farmacopéia britânica e nessa corrente também foi incluída na farmacopéia americana. Porém, na década de 40 percebeu-se os efeitos psicotrópicos da Cannabis com alto teor de THC e dessa forma, o governo americano proibiu o uso de Cannabis para qualquer forma de uso e consequente interrupção das pesquisas. Na década de 60 em Israel, Raphael Mechoulam iniciou novamente as pesquisas com Cannabis a partir de uma porção de maconha apreendida pela polícia. Este cientista foi o primeiro a identificar as moléculas CBD e THC. Na década de 70 professor Elisaudo Carlini publicou um periódico com tratamento de crises epiléticas com CBD em animais sem efeitos no comportamento deles. Mais tarde esse mesmo professor publicou um artigo com 6 pacientes que foram tratados com ótimos resultados com CBD. Na década de 90 identificou-se o sistema endocanabidióide onde achou-se receptores para o CBD em varias partes do corpo humano (pele, olhos, sistema gastrointeistal, etc..) inclusive no cérebro que são os principais alvos de CBD. As principais medicações com Cannabis sativa: 1) CBD isolado e purificado, sem THC, 2) Extrato integral da planta com CBD, THC e flavonóides e no Brasil a concentração de THC é de 0,2%, 3) Extrato integral sem THC, 4) CDB com THC com concentração mais alta de THC. Na pratica clinica é mais utilizada CBD isolado e Extrato integral de Canbbis. Efeito Entourage é o efeito que quando todas as substancias da Cannabis atuam juntas elas melhoram os efeitos do CBD. Principais indicações: Eplepsias refratárias (síndromes de Dravet, West, Lenox Gastaut, entre outras), dor crônica, espasticidade em pacientes com esclerose múltipla e caquexia com anorexia em pacientes com AIDS. Estas indicações tem nível de evidencia forte. Ainda com níveis de evidencias baixos: Autismo, controle comportamental de pacientes com Alzheimer, entre outros. Acesso no Brasil: desde 2014 a Cannabis foi liberada para uso medicinal no Brasil. A primeira forma de acesso foi a importação direta para pessoas que precisam da medicação, porém este processo é demorado e trabalhoso. Recentemente as farmácias foram autorizadas a importar as medicações o que facilitou o acesso à Cannabis. Algumas ONGS conseguiram autorizações liminares para plantar Cannabis no Brasil e extrair o óleo da planta e fornecer para pessoa de baixo poder aquisitivo, pois o produto na farmácia tem alto custo; atualmente estado de SP vai fornecer a medicação custeada pelo SUS. Há famílias que tem autorização judicial para plantar a Cannabis para consumo próprio do CBD. #cannabis #CBD #sistemaendocanabiode #eplepsia #dor #alzheimer #THC
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