In the hospital pharmacy, based on the demand of our clinics and external interested parties, we are starting to prepare medical cannabis, both for vaporizers and for oral use. In December, we start trial preparation of cannabis, assuming the transition to live operation from January 2021. For the preparation of cannabis and other highly effective and toxic drugs, we open a new laboratory-preparation of so-called hazard drugs, equipped with the necessary instruments and equipment, especially with regard to the safety of our pharmacists and pharmaceutical assistants.

Cannabis for medical use is legally available on the Czech market in the form of an individually prepared medicinal product dispensed in pharmacies. It is used as supportive care for serious diseases such as chronic inconsolable pain, neuropathic pain, neurological diseases, multiple sclerosis, nausea, vomiting and loss of appetite in connection with oncological and HIV treatment, rheumatoid arthritis and other diseases. In the Czech Republic, cannabis of the species Cannabis indica L. or Cannabis sativa L. with different content of active substances THC and CBD can be used for therapeutic purposes. The specific ratio of THC to CBD that is ideal for individual patients always depends on the type and manifestations of their disease.

Cannabis for medical use may only be prescribed to a patient by a doctor with a specialist specialization specified in the Cannabis Decree, only in approved indications, exclusively in the form of a restricted electronic prescription. The pharmacy verifies that the maximum amount of cannabis dispensed for a given patient has not been exceeded in a given period (one month). Thus, at the time of dispensing cannabis for medical use to the patient, the pharmacist checks whether the maximum amount of cannabis specified by the decree (180 g) has not been dispensed to the patient in the given period.

 Inhalation using a vaporizer is considered a safe use. In this case, the hemp or the air that flows around it is heated to a temperature of 170-200 ° C. The advantages include a relatively fast onset of action, effective transition to the blood and subsequent spread throughout the body. On the contrary, the disadvantage may be the problematic dosing, especially in patients in need of small doses. The second, most common way of using cannabis is by oral administration. After decarboxylation by heating, the hemp is filled into oral capsules. The advantage is that after consultation with a specialist (doctor or pharmacist), very accurate doses can be prepared with regard to the patient's health. The disadvantage of this route of administration is the delayed onset of action, where the patient may think that the treatment is not working and will take a larger dose, which may in turn cause him to overdose and the difficulties associated with it. Therefore, it is always necessary to follow the dosage prescribed by your doctor.

Cannabis convincingly increases the quality of life in many indicated patients and is usually very well tolerated. The initial low dose is slowly titrated until the desired effect is achieved, which is generally below the limiting effect. We may encounter side effects, in clinical practice it is most often dizziness, as almost the only side effect for which patients cannot use medical cannabis. Typical symptoms of overdose are vomiting, hallucinations, photophobia, dissociation of time perception.