Cannabinoids as Medicines

This online continuing education course provides learners with the knowledge to support patients in the safe and effective use of cannabinoid containing treatments. Learners will be introduced to the complicated history and complex botany of the cannabis plant followed by foundational lectures on the endocannabinoid system and cannabinoid pharmacology. The remaining lectures will focus on the use of cannabinoids for various medical conditions. These lectures will highlight evidence that supports the use of cannabinoids for disease but will also discuss the current limitations of this evidence. Lastly, synthetic cannabinoids and their abuse will be discussed.

Through a series of thirteen modules, taken at your own pace you will receive training in the following areas (see outline below for a brief description of each lecture):

Contested Cannabis – Multiple Perspectives on Medical Marijuana from the Past and Present
Botany of Cannabis
Cannabinoids and terpenes in cannabis; their evolution, roles and controls
The Endocannabinoid System
Cannabinoid Pharmacology
Cannabis in Epilepsy
Cannabinoids for Spasticity
Cannabinoids – Effects on Sleep and Neurodegeneration
Cannabis and Psychiatric Indications
Cannabis Risks
Cannabinoids for the Treatment of Pain
Cannabinoids for the Prevention and Treatment of Chemotherapy-Induced Nausea and Vomiting
Synthetic Cannabinoids, Vape Injury and Abuse

Developed & Conducted by the Division of Pharmacy Professional Development, School of Pharmacy, University of Wisconsin-Madison.

Overview

Course Objectives

As a result of taking this course, the learner will be able to:

Learn the benefits and risks to using cannabinoids to treat disease
Describe the complexity of cannabinoid pharmacology
Explain what evidence is currently lacking for using cannabinoids as disease treatments
Discuss what clinical studies should be done to better understand the effects of various cannabinoids on disease

Outline

Course Outline

Lecture 1	Contested Cannabis – Multiple Perspectives on Medical Marijuana from the Past and Present This presentation will discuss core historical concepts and precedents through case studies in both Britain and America. The political and societal context behind US cannabis drug laws will be covered. Lastly, the current landscape of cannabis regulation in the US and Wisconsin will be presented. (1.0 hours or 0.10 CEU's) Lucas Richert, PhD, Associate Professor, George Urdang Chair in the History of Pharmacy, School of Pharmacy, University of Wisconsin – Madison
Lecture 2	Botany of Cannabis This lecture discusses the basics of cannabis botany including cannabis varieties, structural elements of the cannabis plant, and cannabis cultivation and breeding. Cannabis cultivars will be described with a focus on the varieties of Cannabis sativa L.,which is a primary source of phytocannabinoids. The effects of cannabis cultivation, breeding, and growing conditions on phytocannabinoid profile and content and the potential for unwanted contaminants will be explained. (0.5 hours or 0.05 CEU's) Hunter Land, MS, Associate Director, Cannabinoid Research at Canopy Growth Corporation
Lecture 3	Cannabinoids and Terpenes in Cannabis; their evolution, roles and controls This lecture discusses the evolution, control and roles of cannabis plant cannabinoids and terpenes, which are secondary metabolites not directly involved in the normal growth, development or reproduction of the plant. The role of secondary metabolites is debated and the ability of growers to control the levels of these metabolites is discussed. Finally, the effects of growing conditions, harvest timing and storage on levels of secondary metabolites is discussed. (1.50 hours or 0.15 CEU's) David Potter, JP, PhD, FRSB, FLS, Director of Botanical Research, GW Pharmaceuticals
Lecture 4	The Endocannabinoid System This presentation provides a comprehensive overview of the receptors, enzymes and ligands that comprise the endocannabinoid system. The cannabinoid receptors will be discussed in-depth including their body and tissue distribution, their role in the brain, and their involvement as metabolic and immune effectors. The role of the endocannabinoid system in physiology and disease and the therapeutic strategies and challenges of developing cannabinoids as medicines will also be discussed. (1.0 hours or 0.10 CEU's) Sara Hassan, BPharm, MS, PhD, Pharmaceutical Sciences Division, School of Pharmacy, University of Wisconsin – Madison
Lecture 5	Cannabinoid Pharmacology This presentation covers common terminology used in cannabinoid pharmacology research, a general overview of cannabis botany as it relates to cannabinoid pharmacology, and basic cellular principles of cannabinoid biology. Cannabinoid regulation of cell signaling and inflammation will be discussed. The fundamental pharmacology of THC and CBD, two common cannabinoids, will also be described. (0.75 hours or 0.075 CEU's). Natalie Schmitz, MPA, PharmD, PhD, Assistant Professor, School of Pharmacy, University of Wisconsin – Madison
Lecture 6	Cannabinoids in Epilepsy: Sifting Through the Weeds This lecture reviews cannabinoid pharmacology in the central nervous system with a focus on cannabidiol (CBD) and the CB2 receptor. CBD pharmacokinetics, metabolism and drug interactions will be presented, and the use of CBD to treat epilepsy will be examined in the context of recent clinical trials investigating CBD for Lennox-Gastaut and Dravet Syndromes. Lastly, the types and extent of adverse events observed from the use of CBD in these trials will be discussed. (1.50 hours or 0.15 CEU's) Barry Gidal, PharmD, RPh, FAES, Professor, School of Pharmacy, University of Wisconsin – Madison
Lecture 7	Cannabinoids for Spasticity This lecture describes the basic tenets of spasticity and our current understand of the endocannabinoid system in spasticity. Preclinical and clinical data will be presented that suggests a role for certain cannabinoids in treating spasticity with a focus on clinical trials in multiple sclerosis patients. The challenges to performing spasticity clinical trials with cannabinoids and the limitations to the current data will also be discussed. (1.0 hours or 0.10 CEU's) Natalie Schmitz, MPA, PharmD, PhD, Assistant Professor, School of Pharmacy, University of Wisconsin – Madison
Lecture 8	Cannabinoids – Effects on Sleep and Neurodegeneration This presentation explores the effects of cannabinoids on sleep and neurodegeneration. Data will be presented on the effects of various cannabinoids on sleep disorders including sleep apnea, nightmares due to PTSD, narcolepsy and restless leg syndrome. Rationale for the use of cannabinoids in neurodegenerative disorders such as Parkinson’s disease, dementia, and ALS will also be presented. Lastly, the challenges to interpreting and applying the current clinical research will be discussed throughout the course of the presentation. (1.0 hours or 0.10 CEU's) John Dopp, PharmD, MS, Vice Chair, Associate Professor, Pharmacy Practice Division, School of Pharmacy, University of Wisconsin – Madison
Lecture 9	Cannabis and Psychiatric Indications This presentation will discuss the current clinical data for the use of cannabis for various psychiatric disorders including anxiety, depression ADHA and PTSD. The association between cannabis use and the development of schizophrenia will also be discussed in-depth. Caveats and challenges to the current cannabis research in psychiatric indications will also be presented. (1.25 hours or 0.125 CEU's) Angela Janis, MD, DFAPA, Psychiatrist, Mendota Mental Health Institute
Lecture 10	Cannabis Risks This presentation discusses the relationship between cannabis use and cognitive and physical risks. Current hypotheses will be offered along with outcomes from the latest clinical research. Lastly, the challenges and limitations to interpreting the currently available data will be presented. (0.5 hours or 0.05 CEU's) Angela Janis, MD, DFAPA, Psychiatrist, Mendota Mental Health Institute
Lecture 11	Cannabinoids for the Treatment of Pain This lecture reviews the different types of pain, the ascending and descending pain pathways, and common medications that are currently used for the treatment of pain. The pharmacology behind cannabinoid modulation of pain pathways will be presented. Clinical evidence exploring the benefit of various cannabinoidsfor the treatment of pain disorders will be discussed and compared to other pain treatments. (1.50 hours or 0.15 CEU's) Paul Hutson, PharmD, Professor, Pharmacy Practice Division, School of Pharmacy, University of Wisconsin – Madison
Lecture 12	Cannabinoids for the Prevention and Treatment of Chemotherapy-Induced Nausea and Vomiting This lecture reviews the known pathways associated with nausea and vomiting and common medications used to prevent and treat chemotherapy induced nausea and vomiting (CINV). Based on current clinical research, the benefits of using cannabinoids for prevention and treatment of CINV will be discussed. Finally, how cannabinoids can be integrated into the CINV prevention and treatment strategy will be explored. (1.0 hours or 0.10 CEU's) Paul Hutson, PharmD, Professor, Pharmacy Practice Division, School of Pharmacy, University of Wisconsin – Madison
Lecture 13	Synthetic Cannabinoids, Vape Injury and Abuse This lecture covers the different types of synthetic cannabinoids, the challenges in detecting and regulating these compounds, and the health risks associated with them. The trend in synthetic cannabinoid related emergency department visits will be discussed along with the sources of and legal status of synthetic cannabinoids. Emergency management of synthetic cannabinoid intoxication will be presented and e-cigarette, or vaping, product use-associated lung injury will be discussed in-depth. (1.0 hour or 0.1 CEU's) Cody Wenthur, PharmD, PhD, Assistant Professor, School of Pharmacy, University of Wisconsin – Madison

Instructors

Policy on Disclosure

It is the policy of the University of Wisconsin–Madison Interprofessional Continuing Education Partnership (ICEP) to identify, mitigate and disclose all relevant financial relationships with ineligible companies* held by the speakers/presenters, authors, planners, and other persons who may influence content of this accredited continuing education (CE). In addition, speakers, presenters and authors must disclose any planned discussion of unlabeled/unapproved uses of drugs or devices during their presentation.

For this accredited continuing education activity all relevant financial relationships have been mitigated and detailed disclosures are listed below.

*Ineligible companies are those whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on, patients.

John Dopp, PharmD, MS, Associate Professor, School of Pharmacy, University of Wisconsin – Madison
Financial Relationship Disclosure: Relypsa Pharmaceuticals (Contractor)
Discussion of Unlabeled/Unapproved Uses of Drugs/Devices in Presentation: Yes

Barry Gidal, PharmD, RPh, FAES, Professor, School of Pharmacy, University of Wisconsin – Madison
Financial Relationship Disclosure: Greenwich (Contractor), Eisai (Contractor), UCB (Grant), Sunovion (Contractor)
Discussion of Unlabeled/Unapproved Uses of Drugs/Devices in Presentation: No

Sara Hassan, BPharm, MS, PhD, School of Pharmacy, University of Wisconsin – Madison
Financial Relationship Disclosure: No financial relationships with ineligible companies to disclose
Discussion of Unlabeled/Unapproved Uses of Drugs/Devices in Presentation: Yes

Paul Hutson, PharmD, Professor, School of Pharmacy, University of Wisconsin – Madison
Financial Relationship Disclosure: Patel Kwon, Projections, LLC (Contractor)
Discussion of Unlabeled/Unapproved Uses of Drugs/Devices in Presentation: Yes

Angela Janis, MD, DFAPA, Psychiatrist, Mendota Mental Health Institute
Financial Relationship Disclosure: No financial relationships with ineligible companies to disclose
Discussion of Unlabeled/Unapproved Uses of Drugs/Devices in Presentation: No

Hunter Land, MS, Associate Director, Cannabinoid Research at Canopy Growth Corporation
Financial Relationship Disclosure: Canopy Growth Corporation (Employee)
Discussion of Unlabeled/Unapproved Uses of Drugs/Devices in Presentation: No

David Potter, JP, PhD, FRSB, FLS, Director of Botanical Research, GW Pharmaceuticals
Financial Relationship Disclosure: GW Pharmaceuticals (Employee)
Discussion of Unlabeled/Unapproved Uses of Drugs/Devices in Presentation: No

Lucas Richert, PhD, Associate Professor, George Urdang Chair in the History of Pharmacy, School of Pharmacy, University of Wisconsin – Madison
Financial Relationship Disclosure: No financial relationships with ineligible companies to disclose
Discussion of Unlabeled/Unapproved Uses of Drugs/Devices in Presentation: Yes

Natalie Schmitz, MPA, PharmD, PhD, Assistant Professor, School of Pharmacy, University of Wisconsin – Madison
Financial Relationship Disclosure: No financial relationships with ineligible companies to disclose
Discussion of Unlabeled/Unapproved Uses of Drugs/Devices in Presentation: Yes

Cody Wenthur, PharmD, PhD, Assistant Professor, School of Pharmacy, University of Wisconsin – Madison
Financial Relationship Disclosure: No financial relationships with ineligible companies to disclose
Discussion of Unlabeled/Unapproved Uses of Drugs/Devices in Presentation: Yes

Planning Committee

Leslie Dickmann, PhD, MPH, Program Director, School of Pharmacy, University of Wisconsin – Madison
Financial Relationship Disclosure: No financial relationships with ineligible companies to disclose
Discussion of Unlabeled/Unapproved Uses of Drugs/Devices in Presentation: No
Barry Gidal, PharmD, RPh, FAES, Professor, School of Pharmacy, University of Wisconsin – Madison
Disclosure: see above
Angela Janis, MD, DFAPA, Psychiatrist, Mendota Mental Health Institute
Disclosure: see above
Natalie Schmitz, MPA, PharmD, PhD, Assistant Professor, School of Pharmacy, University of Wisconsin – Madison
Disclosure: see above

CE Credit

ICEP Logo Accreditation Statements

In support of improving patient care, the University of Wisconsin–Madison ICEP is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Credit Designation Statements

Accreditation Council for Pharmacy Education (ACPE)

The University of Wisconsin-Madison ICEP designates this enduring knowledge-based activity for 13.5 hours (1.35 CEUs) of CPE credit. Credit can be earned by successfully completing the assessment (70% or better score) and evaluation. There will be no partial credit awarded for partial completion.

Enduring (home study):

Lecture 1: JA0000358-0000-20-087-H04-P 1.0 hours (0.1 CEUs)
Lecture 2: JA0000358-0000-20-088-H04-P 0.5 hours (0.05 CEUs)
Lecture 3: JA0000358-0000-20-089-H04-P 1.5 hours (0.15 CEUs)
Lecture 4: JA0000358-0000-20-090-H04-P 1.0 hours (0.1 CEUs)
Lecture 5: JA0000358-0000-20-091-H04-P 0.75 hours (0.075 CEUs)
Lecture 6: JA0000358-0000-20-092-H04-P 1.5 hours (0.15 CEUs)
Lecture 7: JA0000358-0000-20-093-H04-P 1.0 hours (0.1 CEUs)
Lecture 8: JA0000358-0000-20-094-H04-P 1.0 hours (0.1 CEUs)
Lecture 9: JA0000358-0000-20-095-H04-P 1.25 hours (0.125 CEUs)
Lecture 10: JA0000358-0000-20-096-H04-P 0.5 hours (0.05 CEUs)
Lecture 11: JA0000358-0000-20-097-H08-P 1.5 hours (0.15 CEUs)
Lecture 12: JA0000358-0000-20-098-H08-P 1.0 hours (0.10 CEUs)
Lecture 13: JA0000358-0000-20-099-H04-P 1.0 hours (0.1 CEUs)

Release Date: 07/15/2020 Expiration Date: 07/15/2023

American Medical Association (AMA)

The University of Wisconsin–Madison ICEP designates this enduring activity for a maximum of 13.5 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Continuing Education Units (CEUs)

The University of Wisconsin–Madison ICEP, as a member of the University Professional & Continuing Education Association (UPCEA), authorizes this program for 1.35 CEUs or 13.5 hours.

Program Coordinator

Leslie Dickmann, PhD, MPH

Division of Pharmacy Professional Development
777 Highland Avenue
Madison, WI 53705
(608) 262-2431 FAX
(608) 265-8249
ljdickmann@wisc.edu