Bertrand J. Shapiro

Acute Pulmonary Physiologic Effects of Smoked Marijuana and Oral Δ9-Tetrahydrocannabinol in Healthy Young Men

Abstract Acute pulmonary physiologic effects of smoked marijuana and oral Δ9-tetrahydrocannabinol were investigated in 32 healthy, experienced male marijuana smokers. After smoking of marijuana ass...

Subacute effects of heavy marihuana smoking on pulmonary function in healthy men.

To evaluate the subacute effects of heavy marihuana smoking on the lung, pulmonary function was tested in 28 healthy young male experienced cannabis users, before and after 47 to 59 days of daily ad-libitum marihuana smoking (mean of 5.2 marihuana cigarettes per day per subject, 2.2 per cent delta9-tetrahydrocannabinol). Base-line pulmonary-function studies were nearly all within normal limits, but after 47 to 59 days of heavy smoking, statistically significant decreases in forced expired volume in one second (3 +/- 1 per cent, S.E.), maximal mid-expiratory flow rate (11 +/- 2 per cent), plethysmographic specific airway conductance (16 +/- 2 per cent) and diffusing capacity (8 +/- 2 per cent) were noted as compared with the base-line studies. The decreases in maximal mid-expiratory flow rate and specific airway conductance were correlated with the quantity of marihuana smoked. These findings suggest that customary social use of marihuana may not result in detectable functional respiratory impairment in healthy young men, whereas very heavy marihuana smoking for six to eight weeks causes mild but statistically significant airway obstruction.

Bronchial effects of aerosolized delta 9-tetrahydrocannabinol in healthy and asthmatic subjects.

Effects on airway dynamics, heart rate, and the central nervous system of various doses of delta9-tetrahydrocannabinol administered in a random, double blind fashion using a Freon-propelled, metered-dose nebulizer were evaluated in 11 healthy men and 5 asthmatic subjects. Effects of aerosolized delta9-tetrahydrocannabinol were compared with aerosolized placebo and isoproterenol and with 20 mg of oral and smoked delta9-tetrahydrocannabinol. In the normal subjects, after 5 to 20 mg of aerosolized delta9-tetrahydrocannabinol, specific airway conductance increased immediately, reached a maximum (33 to 41 per cent increase) after 1 to 2 hours, and remained significantly greater than placebo values for 2 to 3 hours. The bronchodilator effect of aerosolized delta9-tetrahydrocannabinol was less than that of isoproterenol after 5 min, but significantly greater than that of isoproterenol after 1 to 3 hours. The magnitude of bronchodilatation after all doses of aerosolized delta9-tetrahydrocannabinol was comparable, but 5 mg of delta9-tetrahydrocannabinol caused a significantly smaller increase in heart rate and level of intoxication than the 20-mg dose. Smoked delta9-tetrahydrocannabinol produced greater cardiac and intoxicating effects than either aerosolized or oral delta9-tetrahydrocannabinol. Side effects of aerosolized delta9-tetrahydrocannabinol included slight cough and/or chest discomfort in 3 of the 11 normal subjects. Aerosolized delta9-tetrahydrocannabinol caused significant bronchodilatation in 3 of 5 asthmatic subjects, but caused moderate to severe bronchoconstriction associated with cough and chest discomfort in the other 2. These findings indicate that aerosolized delat9-tetrahydrocannabinol, although capable of causing significant bronchodilatation with minimal systemic side effects, has a local irritating effect on the airways, which may make it unsuitable for therapeutic use.

The Management of the Presuicidal, Suicidal, and Postsuicidal Patient

Abstract Between 200,000 and 350,000 Americans attempt suicide each year; about 40,000 succeed. The rate of suicide is rising, particularly in young people in urban areas. Physicians are increasing...

Mechanism of Increased Specific Airway Conductance with Marijuana Smoking in Healthy Young Men.

Excerpt We have previously found that marijuana smoking and ingested delta-9 tetrahydrocannabinol (Δ9THC) increased specific airway conductance in healthy young men. The response was dose-dependent...

Evaluation of Lung Function

Abstract Evaluation of lung function requires evaluation of the function of the entire respiratory apparatus of which the lung is ordinarily the most critical part. It is of diagnostic value in det...

Intrapulmonary shunts in cyanotic congenital heart disease after surgical correction

Abstract Six children with surgically corrected cyanotic congenital heart disease were studied six months to four years after definitive repair. Five had tetralogy of Fallot, and 1 had severe valvular pulmonic stenosis with an atrial septal defect. The bronchial arteries were enlarged and tortuous in all, and intrapulmonary right to left shunts were demonstrated in 4 of the 6 cases. These shunts appear to reflect venous admixture rather than true anatomic connections between the bronchial and pulmonary circulations.