Cannabis und synthetische Cannabinoide – eine nicht nur radiologische Übersicht

Zusammenfassung

Eine Übersicht zum „Drogenabusus“ mit Schwerpunkt Radiologie kann sich nicht auf rein bildmorphologisch fassbare Veränderungen beschränken. Vielmehr muss der Radiologe über Wirkungsweise und Art des Konsums der einzelnen Stoffklassen informiert sein und das Spektrum an zu erwartenden Komplikationen und Langzeitveränderungen kennen. In diesem Beitrag stehen Cannabis und synthetische Cannabinoide im Mittelpunkt.

Abstract

A radiological overview concerning abusus of different drugs and substances cannot be limited to morphological and radiological findings. The radiologist must additionally be informed about the mode of pathophysiological effects, as well as the different types of consumption, complications and long-term-changes of the individual substances. The main aspects of the present overview will be Cannabis and synthetic Cannabinoids.

Kernaussagen

• Radiologen sollten für ihre Arbeit neben den rein bildmorphologisch fassbaren Veränderungen auch die Wirkungsweise und die Art des Konsums von Cannabis und synthetischen Cannabinoiden kennen.

• Die hinsichtlich ihrer Wirkungsweise am besten untersuchten Phytocannabinoide sind das Δ 9-Trans-Tetrahydrocannabinol (THC, bindet an CB1-Rezeptoren) und das Cannabidiol (CBD, schwache Affinität zu CB1- und CB2-Rezeptoren).

• Die Gefäßwirkung von Cannabis kann zwischen ausgeprägter Vasokonstriktion und Vasodilatation variieren und betrifft sowohl periphere Gefäße als auch die Gefäße des ZNS. Außerdem fördert Cannabis die Thrombozytenaggregation. Die 3 wichtigen kardialen Komplikationen des Cannabis-Abusus sind Arrhythmien, Myokardinfarkt und Kardiomyopathie. Andere unerwünschte Wirkungen sind die Beeinträchtigung kognitiver Leistungen und psychiatrische Komplikationen.

• In Kollektiven fand sich ein signifikant geringeres Volumen der grauen Substanz des Hippocampus und des orbitofrontalen Kortex nach Cannabis-Abusus.

• Die Cannabis-Arteriitis ist eine seltene Form der Arteriitis, die alle größeren Arterien des Unterschenkels und ihre Äste (und auch die der Arme) betreffen kann.

• Synthetische Cannabinoide weisen eine sehr viel stärkere Rezeptorbindung auf als THC. Sie haben ein ähnliches Spektrum von Symptomen wie Cannabis, jedoch mit höherer Wahrscheinlichkeit des Auftretens und oft letalem Ausgang.

Schlüsselwörter

Cannabis - Marihuana - synthetische Cannabinoide - Cannabis-Arteriitis

Key words

cannabis - marijuana - synthetic cannabinoids - cannabis arteritis

Publication History

Article published online:
27 April 2021

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