Dronabinol

Dronabinol is a synthetic Δ⁹-tetrahydrocannabinol. Dronabinol primarily binds to CB₁ and CB₂ receptors in the central nervous system and peripheral tissues. CB₁ receptors are distributed in regions such as the cerebral cortex, hippocampus, hypothalamus, basal ganglia, and cerebellum. When dronabinol activates CB₁ receptors, it inhibits adenylate cyclase activity, lowers cAMP levels, suppresses calcium influx, and promotes potassium efflux. This reduces the release of neurotransmitters such as GABA, glutamate, and serotonin, thereby modulating neural pathways involved in nausea and vomiting reflexes, appetite, and central sedation, and may also produce psychoactive central effects. In addition, activation of CB₂ receptors, which are mainly located on immune cells, suppresses cytokine release from inflammatory cells and contributes to anti-inflammatory and immunomodulatory effects.