2.__Gen_Ed__Support_to_patients_related_to_patients_symptom.pdfs.pdf

Continuing Education Module #2 for the OMMCP

1. Support to patients related to
patient symptoms

2. Goals of this lesson
1.Understand various patient symptoms related
to qualifying conditions for the Ohio Medical
Marijuana Program
2.Understand the Adverse Reactions
associated with the use of Medical Marijuana
3.There is quiz link for this section on Slide 29
that will need submitted for credit
4.

3. AIDS
•Acquired Immune Deficiency Syndrome – late stage
of HIV infection
•HIV – Human Immunodeficiency Virus
•A virus that attacks the cells that help the body fight
infection
•Symptoms include:
Flu like Symptoms such as fever, chills, muscle aches and
sore throat
AIDs (late stage HIV infection) symptoms include:
rapid weight loss, cachexia (wasting and weakness of the
body), pneumonia, memory loss







Reference: HIV.gov https://www.hiv.gov/hiv-basics/overview/about-hiv-and-aids/symptoms-of-hiv

4. ALS
•Amyotrophic Lateral Sclerosis
•Also referred to as Lou Gehrig’s Disease
•Symptoms include:
Selective Degeneration of Motor Neurons
Pain, muscle cramps, spasticity, anorexia, wasting, dyspnea,
sialorrhea, anxiety and depression

Death occurs usually from respiratory failure within
2-5 years of symptom onset







Reference: Mayo Clinic:
https://www.mayoclinic.org/diseases-conditions/alzheimers-disease/symptoms-causes/syc-20350447#:~:text=Alzheimer's%20diseas
e%20is%20a%20progressive,person's%20ability%20to%20function%20independently.

5. Alzheimers Disease
•Affects 5.7 million Americans and # is projected to be 14
million by 2050
•Symptoms include:
Memory loss that disrupts life, challenges in planning or
solving problems, new problems with words in speaking or
writing, changes in mood or personality, confusion with time
or place, misplacing things or losing the ability to retrace
steps
One symptom currently being studied is nighttime
excursions.










Reference: Mayo Clinic:
https://www.mayoclinic.org/diseases-conditions/alzheimers-disease/symptoms-causes/syc-20350447#:~:text=Alzheimer's%20diseas
e%20is%20a%20progressive,person's%20ability%20to%20function%20independently.

6. Cachexia
•Cachexia is a syndrome characterized by loss of
appetite, weight, and skeletal muscle, leading to
fatigue, functional impairment,  increased
treatment-related toxicity,  poor quality of life,  and
reduced survival.
 


•Cachexia often occurs in patients with cancer
•This syndrome affects people who are in the late
stages of serious diseases like cancer, HIV or
AIDS, COPD, kidney disease, and congestive heart
failure (CHF).






Reference: CDD.gov: https://www.cdc.gov/ibd/index.htm.

7. Cancer
•According to the CDC, cancer is the 2nd leading cause of death
among Americans
•The National Cancer Institute states that cancer is “the name
given to a collection of related diseases” and is when the
body’s cells begin to divide without stopping and spread into
surrounding tissues
•Symptoms include:
•Chemotherapy induced peripheral neuropathy pain which is described as a
prickly pain often in the hands and feet which can affect your ability to
write, walk or button your shirt
•Cancer Pain is a more generalized pain that can occur anywhere in the
body and can affect sleep and other day to day activities
•Chemotherapy induced nausea and vomiting or CINV is generally caused
by the treatments used to fight cancer and can often be severe and
debilitating







Reference: American Cancer Society: https://www.cancer.org/

8. CTE
•Chronic Traumatic Encephalopathy is a progressive
neurological deterioration associated with repetitive
brain trauma
•CTE is a particularly severe form of traumatic brain
injury
•Symptoms include:
Unconsciousness, inability to remember the cause of the
injury or events that occurred immediately or up to 24 hours
after, confusion, disorientation, headache, dizziness, nausea
and vomiting or ringing in the ears







Reference: Concussion Foundation https://concussionfoundation.org/CTE-resources/what-is-CTE

9. Crohn’s Disease
•Crohn’s disease is a form of inflammatory bowel disease in
which there is chronic inflammation in the digestive tract as
a result of an abnormal immune response
•Signs and Symptoms
•Diarrhea, Abdominal pain, rectal bleeding, urgent need to
move bowels.
•Other more general symptoms include: Sensation of
incomplete evacuation, fever, loss of appetite, weight
loss, fatigue, night sweats or loss of normal menstrual
cycle






Reference: CDD.gov: https://www.cdc.gov/ibd/index.htm.

10. Epilepsy
•Epilepsy is a group of related disorders characterized by
tendency for recurrent seizures. It is diagnosed in 125,000
Americans each year
•Seizure types can be divided into:
•Focal-Onset Seizures (previously referred to as partial
seizures)
•Generalized Onset Seizures (occurring in both sides of
the brain)
•Symptoms include:
Patients symptoms can be wide ranging and may include
loss of consciousness or inability to communicate






Reference: Medscape https://www.medscape.com/viewarticle/904131#vp_3

11. Fibromyalgia
•Fibromyalgia is a chronic disorder characterized by
widespread pain, tenderness and fatigue
•Symptoms include:
Pain in joints and tissues, potentially widespread
musculoskeletal pain accompanied by fatigue, sleep-
memory and mood issues.








Reference: Medscape https://emedicine.medscape.com/article/329838-overview

12. Glaucoma
•Primary open-angle glaucoma (POAG) is described distinctly
as a multifactorial optic neuropathy that is chronic,
progressive, and irreversible, with a characteristic acquired
loss of optic nerve fibers. Intraocular pressure develops that
is too high for the continued health of the eye
•Symptoms :
Because of the silent nature of glaucoma, patients usually don’t
present with any symptoms or visual complaints until late in
the disease course, particularly with primary open-angle
glaucoma. However, narrow/closed-angle glaucoma and
secondary glaucomas can cause a rapid rise in intraocular
pressure, which is usually symptomatic, particularly when
intraocular pressure is 35 mm Hg or more.






Reference: Medscape:
https://emedicine.medscape.com/article/1206147-overview

13. Hepatitis C
•Hepatitis C is an infection caused by the hepatitis C virus
(HCV) that attacks the liver and leads to inflammation. The
World Health Organization (WHO) estimates that about 71
million people globally have chronic hepatitis C, with
approximately 399,000 dying from this infection
•Initial Symptoms include:
Arthritic type pain, generalized pain, itching and neuropathy
•Advanced Symptoms:
•Mental Status changes, ankle edema and variceal
bleeding (blood in the esophagus)









Reference: Medscape Overview: https://emedicine.medscape.com/article/177792-overview

14. IBD
•Inflammatory Bowel Disease (IBD) is a broad term that
describes conditions characterized by chronic inflammation
of the gastrointestinal tract. Can include conditions such as
Crohn’s Disease and Ulcerative Colitis
•Symptoms include:
Persistent diarrhea, abdominal pain, rectal bleeding, weight
loss and fatigue







Reference: CDD.gov: https://www.cdc.gov/ibd/index.htm.

15. MS
•Multiple sclerosis (MS) is an immune-mediated
inflammatory disease that attacks myelinated axons
in the central nervous system
•More than 30% of patients develop significant
physical disability within 20-25 years.
•Symptoms include:
Sensory Loss, muscle cramping, bladder, bowel and
sexual dysfunctions, facial weakness (trigeminal
neuralgia), heat intolerance, or depression.





Reference: Medscapehttps://emedicine.medscape.com/article/1146199-overview.

16. Pain that is either chronic & severe or intractable
•Pain that usually lasts longer than 3-6 months
•Approximately 35% of Americans have some
element of chronic pain and it is more common
in women
•Symptoms include:
Depressed mood, poor-quality or nonrestorative
sleep, fatigue, reduced activity and libido,
excessive use of drugs and alcohol, dependent
behavior, and disability.






Reference: Medscape: https://emedicine.medscape.com/article/310834-overview.

17. Parkinson Disease
•Parkinson disease (PD) is one of the most common
neurologic disorders and the 2 major neuropathologic
findings are loss of pigmented dopaminergic neurons of the
substantia nigra pars compacta and the presence of Lewy
bodies and Lewy neurites. It usually affects individuals over
the age of 60.
•Symptoms include:
Tremor, decrease in arm-swing on the first-involved side,
soft voice, decreased facial expression, sleep disturbances,
decreased sense of smell, general feeling of weakness,
slowness in thinking, gait difficulty and rigidity.







Reference: Medscape Parkinson Reviewhttps://emedicine.medscape.com/article/1831191-overview.

18. Positive Status for HIV
•In the United States, by the end of 2015, the CDC estimated that 1.1
million persons aged 13 years or older were living with HIV infection.
•Early diagnosis of HIV infection is of paramount importance, allowing
health care providers an invaluable opportunity to prevent further
transmission of the disease and to begin therapy, if warranted
•Other information:
•Up to 15% of patients are unaware of their positive diagnosis
•The CDC recommends that all persons aged 13-64 years should
have routine HIV testing.
•Positive HIV can lead to development of AIDS if left
untreated






Reference: Medscape HIV Overview: https://emedicine.medscape.com/article/2061077-overview

19. PTSD
•Post-traumatic stress disorder (PTSD) is a mental
health condition that's triggered by a terrifying event
— either experiencing it or witnessing it.
•Symptoms include:
Flashbacks, nightmares, severe anxiety as well as
uncontrollable thoughts about the event







Reference: Mayo
Clinichttps://www.mayoclinic.org/diseases-conditions/post-traumatic-stress-disorder/symptoms-causes/syc-20355967.

20. Sickle Cell Anemia
•Sickle cell disease is an inherited blood disorder that
affects red blood cells. 
•Sickle cell conditions are inherited from parents in
much the same way as blood type, hair color and
texture, eye color and other physical traits.
•Symptoms include:
Anemia, jaundice and gallstones. As it affects the flow of
blood through vessels it may cause lung issues (acute chest
syndrome), pain episodes most commonly in the arms, legs,
chest and abdomen.





Reference: Sickle Cell Foundation: https://www.sicklecelldisease.org/sickle-cell-health-and-disease/types/

21. Spinal Cord Disease or Injury
•Spinal cord injury (SCI) or disease is an insult to the spinal
cord resulting in a change, either temporary or permanent, in
the cord’s normal motor, sensory, or autonomic function.
•Symptoms can be arranged in an ABCD or E fashion based
on the parts of the spinal cord affected:
A = Complete: No sensory or motor function is preserved in sacral segments S4-S5
 [3]

B = Incomplete: Sensory, but not motor, function is preserved below the neurologic level and
extends through sacral segments S4-S5
C = Incomplete: Motor function is preserved below the neurologic level, and most key muscles
below the neurologic level have a muscle grade of less than 3
D = Incomplete: Motor function is preserved below the neurologic level, and most key muscles
below the neurologic level have a muscle grade that is greater than or equal to 3
E = Normal: Sensory and motor functions are normal







Reference: Medscapehttps://emedicine.medscape.com/article/793582-overview.

22. Tourette’s Syndrome
•Tourette Syndrome (TS) is a condition of the nervous system.
TS causes people to have “tics”. These tics can be separated
into Motor and Vocal forms.
•Symptoms usually begin when a child is 5-10 years old.
•Symptoms :
The first symptoms are often motor tics that occur in the
head and neck area and are usually worse in times of stress.
Vocalization or corprolalia symptoms are rarer than motor.







Reference: CDC.govhttps://www.cdc.gov/ncbddd/tourette/facts.html.

23. TBI
•Traumatic brain injury (TBI) is a nondegenerative,
noncongenital insult to the brain from an external
mechanical force, possibly leading to permanent or
temporary impairment of cognitive, physical, and
psychosocial functions, with an associated diminished or
altered state of consciousness.

•Symptoms Include:
•Insomnia, cognitive decline, fatigue, headaches,
depression, dizziness, weakness and memory loss






Reference: Medscapehttps://emedicine.medscape.com/article/326643-overview#a7.

24. Ulcerative Colitis
•Ulcerative Colitis is a form of Inflammatory Bowel Disease
and occurs in the large intestine and rectum. It is
differentiated from Crohn’s disease by its less patchy and
more continuous damaged areas and usually starts in the
rectum.
•Symptoms include:
Persistent diarrhea
Abdominal pain
Rectal bleeding/bloody stools
Weight loss
Fatigue






Reference: CDD.gov: https://www.cdc.gov/ibd/index.htm.

25. Other qualifying conditions
•In February 2021, the State Medical Board of Ohio
determined the following conditions are considered covered
by an existing qualifying condition: arthritis chronic
migraines and complex region pain syndrome. These
conditions were determined to be covered by pain that is
either chronic or intractable.





Reference: Healthline Cachexia: Definition, Treatment, and Relation to Cancer (healthline.com)

26. Common Adverse Effects of Marijuana

27. The role of the dispensary employee
●Each dispensary technician and brand ambassador must understand the
potential symptoms of each the 23 qualifying conditions in the Ohio Program
●Patients may ask questions about each condition before they purchase a
product
●Each condition has the potential for not only success in treatment with medical
marijuana but also adverse reactions and potential worsening of symptoms of
each condition.
●The staff should direct these questions to the FRX pharmacist to discuss in
more detail

28. Toll Free Help line in Ohio
The Ohio Medical Marijuana Control Program
Tool-Free Helpline responds to inquiries from
patients, caregivers, and health professionals
regarding adverse reactions to medical
marijuana, and provides information about
available services and additional assistance as
needed. 
○ HELPLINE: 1-833-4OH-MMCP (1-833-464-6627) 

29. Q & A

Support for Patients Related to Patient Symptoms
Quiz Link for the following slides: https://forms.gle/MToMUwMaoVFwKcDw6

30. Question #1





Which of the following Ohio qualifying conditions is associated with
tremors?
a)Ulcerative Colitis
b)Traumatic Brain Injury
c)Acquired Immune Deficiency Syndrome
d)Parkinson Disease

Support for Patients Related to Patient Symptoms

31. Question #2


Which of the following Ohio Qualifying Conditions is associated with tics?
a)Crohn’s Disease
b)Cancer
c)Tourette’s Syndrome
d)Chronic Traumatic Encephalopathy

Support for Patients Related to Patient Symptoms

32. Question #3
Medical questions that a dispensary technician
cannot answer should be directed to:
a)Toll Free Helpline
b)Dispensary Pharmacist
c)Either A or B




Support for Patients Related to Patient Symptoms

33. Question #4
Adverse reactions to cannabis include all of the following except:
a) Red eyes
b) Dry Mouth
c) Decreased eye blink rate
d) Increased sperm count





Support for Patients Related to Patient Symptoms

34. Question #5
Chronic pain can be defined as pain that has continued to occur over:
a) 3 weeks
b) More than 2 weeks in a row
c) More than 3-6 months
d) 2 months






Support for Patients Related to Patient Symptoms

35. Question #6
Symptoms of chronic pain include all of the following except:
a) Poor sleep quality
b) Excessive use of drugs and alcohol
c) Fatigue
d) Increased libido





Support for Patients Related to Patient Symptoms

36. Question #7
Cannabis may cause a worsening of the symptoms of some of the
qualifying conditions
a) True
b) False


Support for Patients Related to Patient Symptoms

37. Question #8
The newest qualifying condition allowed in Ohio is:
a) Cachexia
b) Complex Regional Pain Syndrome
c) Chronic Migraines
d) Arthritis


Support for Patients Related to Patient Symptoms