The Drug-Induced Cardiotoxicity Website and App

Marijuana, cannabis (haschish, hash, bang, dab)

Some adverse effects of marijuana may overlap with those of tobacco smoke. Not all studies confirmed whether marijuana per se is harmful to the airways (PMID 29629404). Variation in cannabis/marijuana/haschich potency, concentration (e.g. resin, hash oil), contamination with fungi (PMID 6348548) and possible adulteration should be considered (PMID:18494838). Reviews at PMID 24831571, 24897085, 25996274, 26935046, 29629404, 29971337. Some users vaporize cannabis using electronic cigarette devices (PMID 30835796)

Frequency - Incidence

Incidence of cardiac adverse event(s) due to the specific drug as assessed by number of reported/published cases in the literature. Red digits in stars indicate: 0 = Very rare, questionable signal · 1 = < 10 cases · 2 = 10-50 cases · 3 = 50–100 cases · 4 = 100-200 cases · 5 = >200 cases

Evidence level/grade

Evidence level for cardiac adverse event(s) due to the specific drug as estimated using Hill’s (1965), Naranjo’s (1981), and Bégaud’s (1985) criteria applied to published cases. Blue digits in stars indicate: 0 = Questionable · 1 = Low · 2 = Moderate · 3 = Robust · 4 = Definite · 5 = Unquestionable, pathognomonic

II - Cardiac arrhythmia(s)/dysrhythmia(s) (AF, VT, VF, TdP) - QTc prolongation)

II.a

Cardiac arrhythmias or dysrhythmias (AF, VT, VF, TdP)

II.j

Asystole

III - Myocardial ischemia - Coronary artery disease

III.a

Coronary artery disease (acute) - Myocardial ischemia/infarction

III.c

Coronary vasospasm - Vasospastic angina

III.e

Coronary artery dissection

IV - Heart block (bundle branch-, AV-block)

IV.a

Heart block (bundle branch- or AV-)

V - Myocarditis

V.a

Myocarditis (can be fulminant)

XII - Pericardial involvement

XII.b

Pericardial effusion (w/wo tamponade)

XIV - Pleural involvement

XIV.a

Pleural effusion (uni- or bilateral) (can accompany DI-LDs)

XIV.f

Pneumothorax

XIV.l

Pneumothorax, bilateral

XV - Chest pain

XV.a

Chest pain (acute or subacute), lone or prominent

XVI - Hemorrhage - Bleeding - Hematoma

XVI.e

Alveolar hemorrhage (AH), diffuse AH (DAH)

XVI.i

Hemoptysis

XXI - Mediastinal involvement/injury

XXI.c

Pneumomediastinum

XXII - Acute respiratory/cardiorespiratory failure

XXII.b

ARDS - Acute lung injury

XXII.e

Respiratory failure from ventilatory depression (due to neuromuscular blockade/paralysis)

XXIV - Interstitial lung disease - Pulmonary infiltrates - Pulmonary fibrosis

XXIV.b

Pneumonitis (ILD), acute and/or severe (may produce the ARDS pattern)

XXIV.c

Eosinophilic pneumonia (pulmonary infiltrates and eosinophilia)

XXIV.d

Acute eosinophilic pneumonia (AEP)

XXIV.l

Pulmonary infiltrates

XXIV.z

Exogenous lipoid pneumonia (subacute, acute)

XXIV.ad

Pulmonary alveolar proteinosis (PAP) (secondary)

XXIV.af

Pneumoconiosis (silicosis, talcosis...)

XXIV.ag

Hypersensitivity pneumonitis pattern

XXIX - Small airway involvement

XXIX.d

Cough (lone)

XXXVI - Autoimmune syndromes - Systemic reactions or conditions

XXXVI.f

Anaphylaxis-Anaphylactoid reaction (can be fatal)

XXXVIII - Miscellaneous - Varia

XXXVIII.e

Sniffing death - Death from inhalation of compound