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https://www.readbyqxmd.com/read/28597354/pharmacologic-considerations-for-pediatric-sedation-and-anesthesia-outside-the-operating-room-a-review-for-anesthesia-and-non-anesthesia-providers
#1
REVIEW
Narjeet Khurmi, Perene Patel, Molly Kraus, Terrence Trentman
Understanding the pharmacologic options for pediatric sedation outside the operating room will allow practitioners to formulate an ideal anesthetic plan, allaying anxiety and achieving optimal immobilization while ensuring rapid and efficient recovery. The authors identified relevant medical literature by searching PubMed, MEDLINE, Embase, Scopus, Web of Science, and Google Scholar databases for English language publications covering a period from 1984 to 2017. Search terms included pediatric anesthesia, pediatric sedation, non-operating room sedation, sedation safety, and pharmacology...
June 8, 2017: Paediatric Drugs
https://www.readbyqxmd.com/read/28550529/single-administration-of-hbk-15-a-triple-5-ht1a-5-ht7-and-5-ht3-receptor-antagonist-reverses-depressive-like-behaviors-in-mouse-model-of-depression-induced-by-corticosterone
#2
Karolina Pytka, Monika Głuch-Lutwin, Magdalena Kotańska, Anna Waszkielewicz, Agnieszka Kij, Maria Walczak
Studies suggest that the blockade of 5-HT1A, 5-HT7, and 5-HT3 receptor may increase the speed of antidepressant response. 1-[(2,6-Dimethylphenoxy)ethoxyethyl]-4-(2-methoxyphenyl)piperazine hydrochloride (HBK-14) and 1-[(2-chloro-6-methylphenoxy)ethoxyethyl]-4-(2-methoxyphenyl)piperazine hydrochloride (HBK-15), dual 5-HT1A and 5-HT7 antagonists, showed significant antidepressant- and anxiolytic-like properties in our previous tests in rodents. In this study, we aimed to investigate their antidepressant potential using mouse model of corticosterone-induced depression...
May 26, 2017: Molecular Neurobiology
https://www.readbyqxmd.com/read/28473755/the-combination-of-long-term-ketamine-and-extinction-training-contributes-to-fear-erasure-by-bdnf-methylation
#3
Ling-Sha Ju, Jiao-Jiao Yang, Lei Lei, Jiang-Yan Xia, Dan Luo, Mu-Huo Ji, Anatoly E Martynyuk, Jian-Jun Yang
A combination of antidepressant drugs and psychotherapy exhibits more promising efficacy in treating fear disorders than either treatment alone, but underlying mechanisms of such treatments remain largely unknown. Here we investigated the role of DNA methylation of the brain-derived neurotrophic factor (Bdnf) gene in the therapeutic effects of ketamine in combination with extinction training in a mouse model of post-traumatic stress disorder (PTSD) induced by inescapable electric foot shocks (IFS). Male mice received ketamine for 22 consecutive days starting 1 h after the IFS (long-term ketamine treatment) or 2 h prior to the extinction training on days 15 and 16 after the IFS (short-term ketamine treatment)...
2017: Frontiers in Cellular Neuroscience
https://www.readbyqxmd.com/read/28441895/ketamine-s-dose-related-effects-on-anxiety-symptoms-in-patients-with-treatment-refractory-anxiety-disorders
#4
Paul Glue, Natalie J Medlicott, Sarah Harland, Shona Neehoff, Bridie Anderson-Fahey, Martin Le Nedelec, Andrew Gray, Neil McNaughton
The N-methyl-D-aspartate receptor antagonist ketamine has rapid onset activity in treatment-resistant depression, post-traumatic stress disorder and obsessive compulsive disorder. Due to similarities in brain network activity in depression and anxiety disorders, we hypothesized that ketamine might also be active in other refractory anxiety disorders. We evaluated the efficacy and safety of ketamine in 12 patients with refractory generalized anxiety disorder and/or social anxiety disorder who were not currently depressed, using an ascending single dose study design (0...
April 1, 2017: Journal of Psychopharmacology
https://www.readbyqxmd.com/read/28438555/amygdala-activity-associated-with-social-choice-in-mice
#5
Takuma Mihara, Kobina Mensah-Brown, Rosanna Sobota, Robert Lin, Robert Featherstone, Steven J Siegel
Studies suggest that the amygdala is a key region for regulation of anxiety, fear and social function. Therefore, dysfunction of the amygdala has been proposed as a potential mechanism for negative symptoms in schizophrenia. This may be due to NMDA receptor-mediated hypofunction, which is thought to be related to the pathogenesis of schizophrenia. In this study, electroencephalographic amygdala activity was assessed in mice during the three-chamber social test. This activity was also evaluated following exposure to the NMDA receptor antagonist ketamine...
April 21, 2017: Behavioural Brain Research
https://www.readbyqxmd.com/read/28415832/the-synergistic-effect-of-dual-use-of-amphetamine-type-stimulants-and-ketamine-on-drug-induced-psychotic-symptoms-in-chinese-synthetic-drug-users
#6
Xue-Bing Liu, Yao Zhang, Xu-Yi Wang, Wei Hao
The use of amphetamine-type stimulants (ATS) and ketamine is of particular clinical concern because of its associated psychotic symptoms. In Chinese clinical practice, ATS and ketamine are commonly used simultaneously, but very few studies have reported the symptom profile of users who use both drugs. This study determined whether the combined use of ATS and ketamine is associated with more psychotic symptoms than either ATS or ketamine alone. According to drug use characteristics, 375 Chinese synthetic drug users were categorized into 2 pairs of comparison groups: ATS-only (n=125) vs...
March 22, 2017: Oncotarget
https://www.readbyqxmd.com/read/28384832/obsessive-compulsive-disorder-advances-in-diagnosis-and-treatment
#7
REVIEW
Matthew E Hirschtritt, Michael H Bloch, Carol A Mathews
Importance: Obsessive-compulsive disorder (OCD) is a neuropsychiatric disorder associated with significant impairment and a lifetime prevalence of 1% to 3%; however, it is often missed in primary care settings and frequently undertreated. Objective: To review the most current data regarding screening, diagnosis, and treatment options for OCD. Evidence Review: We searched PubMed, EMBASE, and PsycINFO to identify randomized controlled trials (RCTs), meta-analyses, and systematic reviews that addressed screening and diagnostic and treatment approaches for OCD among adults (≥18 years), published between January 1, 2011, and September 30, 2016...
April 4, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28373844/effects-of-ketamine-on-levels-of-inflammatory-cytokines-il-6-il-1%C3%AE-and-tnf-%C3%AE-in-the-hippocampus-of-mice-following-acute-or-chronic-administration
#8
Yanning Li, Ruipeng Shen, Gehua Wen, Runtao Ding, Ao Du, Jichuan Zhou, Zhibin Dong, Xinghua Ren, Hui Yao, Rui Zhao, Guohua Zhang, Yan Lu, Xu Wu
Ketamine is an injectable anesthetic and recreational drug of abuse commonly used worldwide. Many experimental studies have shown that ketamine can impair cognitive function and induce psychotic states. Neuroinflammation has been suggested to play an important role in neurodegeneration. Meanwhile, ketamine has been shown to modulate the levels of inflammatory cytokines. We hypothesized that the effects of ketamine on the central nervous system are associated with inflammatory cytokines. Therefore, we set out to establish acute and chronic ketamine administration models in C57BL/6 mice, to evaluate spatial recognition memory and emotional response, to analyze the changes in the levels of the inflammatory cytokines interleukin-6 (IL-6), interleukin-1β (IL-1β), and tumor necrosis factor-α (TNF-α) in the mouse hippocampus, employing behavioral tests, Western blot, quantitative reverse transcriptase-polymerase chain reaction (qRT-PCR) and immunohistochemistry...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28338546/a-double-blind-placebo-controlled-pilot-study-of-riluzole-monotherapy-for-acute-bipolar-depression
#9
Lawrence T Park, Marc S Lener, Matthew Hopkins, Nicolas Iadorola, Rodrigo Machado-Vieira, Elizabeth Ballard, Allison Nugent, Carlos A Zarate
BACKGROUND: Glutamatergic system abnormalities are implicated in the pathophysiology and treatment of both major depressive disorder and bipolar depression (BDep). Subsequent to studies demonstrating the rapid and robust antidepressant effects of ketamine, an N-methyl-D-aspartate receptor antagonist, other glutamatergic modulators are now being studied in clinical trials of mood disorders. A previous open-label study found that riluzole, administered in combination with the mood stabilizer lithium, had antidepressant effects...
June 2017: Journal of Clinical Psychopharmacology
https://www.readbyqxmd.com/read/28249076/a-consensus-statement-on-the-use-of-ketamine-in-the-treatment-of-mood-disorders
#10
REVIEW
Gerard Sanacora, Mark A Frye, William McDonald, Sanjay J Mathew, Mason S Turner, Alan F Schatzberg, Paul Summergrad, Charles B Nemeroff
Importance: Several studies now provide evidence of ketamine hydrochloride's ability to produce rapid and robust antidepressant effects in patients with mood and anxiety disorders that were previously resistant to treatment. Despite the relatively small sample sizes, lack of longer-term data on efficacy, and limited data on safety provided by these studies, they have led to increased use of ketamine as an off-label treatment for mood and other psychiatric disorders. Observations: This review and consensus statement provides a general overview of the data on the use of ketamine for the treatment of mood disorders and highlights the limitations of the existing knowledge...
April 1, 2017: JAMA Psychiatry
https://www.readbyqxmd.com/read/28122258/effects-of-early-or-late-prenatal-immune-activation-in-mice-on-behavioral-and-neuroanatomical-abnormalities-relevant-to-schizophrenia-in-the-adulthood
#11
Vivian T da Silveira, Daniel de Castro Medeiros, Jivago Ropke, Patricia A Guidine, Gustavo H Rezende, Marcio Flavio D Moraes, Eduardo Mazoni A M Mendes, Danielle Macedo, Fabricio A Moreira, Antonio Carlos P de Oliveira
Maternal immune activation (MIA) during pregnancy in rodents increases the risk of the offspring to develop schizophrenia-related behaviors, suggesting a relationship between the immune system and the brain development. Here we tested the hypothesis that MIA induced by the viral mimetic polyinosinic-polycytidylic acid (poly I:C) in early or late gestation of mice leads to behavioral and neuroanatomical disorders in the adulthood. On gestational days (GDs) 9 or 17 pregnant dams were treated with poly I:C or saline via intravenous route and the offspring behaviors were measured during adulthood...
May 2017: International Journal of Developmental Neuroscience
https://www.readbyqxmd.com/read/27933364/behavioral-alterations-of-zebrafish-larvae-after-early-embryonic-exposure-to-ketamine
#12
Luís M Félix, Luís M Antunes, Ana M Coimbra, Ana M Valentim
RATIONALE: Ketamine has been associated with pediatric risks that include neurocognitive impairment and long-term behavioral disorders. However, the neurobehavioral effects of ketamine exposure in early development remain uncertain. OBJECTIVES: This study aimed to test stage- and dose-dependent effects of ketamine exposure on certain brain functions by evaluating alterations in locomotion, anxiety-like and avoidance behaviors, as well as socialization. METHODS: Embryos were exposed to different concentrations of ketamine (0, 0...
December 8, 2016: Psychopharmacology
https://www.readbyqxmd.com/read/27928474/comparison-effect-of-intravenous-ketamine-with-pethidine-for-analgesia-and-sedation-during-bone-marrow-procedures-in-oncologic-children-a-randomized-double-blinded-crossover-trial
#13
Babak Abdolkarimi, Soheila Zareifar, Majid Golestani Eraghi, Fazl Saleh
Background: Children suffering from cancer always require pain relief and reduce anxiety when undergoing painful procedures. The aim of this study is to compare the effect of pethedine and ketamine administration in cancer-diagnosed children undergoing bone marrow aspiration and biopsy procedures. Subjects and Methods: A randomized, double-blinded, crossover trial was carried out on 57 children undergoing painful procedures (bone marrow aspiration/biopsy). Patients were randomly assigned in a double-blinded fashion to receive either intravenous pethedine (1 mg/kg/dose) or ketamine (1 mg/kg/dose), respectively...
October 1, 2016: International Journal of Hematology-oncology and Stem Cell Research
https://www.readbyqxmd.com/read/27740963/investigation-of-antidepressant-like-and-anxiolytic-like-actions-and-cognitive-and-motor-side-effects-of-four-n-methyl-d-aspartate-receptor-antagonists-in-mice
#14
Louise K Refsgaard, Darryl S Pickering, Jesper T Andreasen
Evidence suggests that N-methyl-D-aspartate receptor (NMDAR) antagonists could be efficacious in treating depression and anxiety, but side effects constitute a challenge. This study evaluated the antidepressant-like and anxiolytic-like actions, and cognitive and motor side effects of four NMDAR antagonists. MK-801, ketamine, S-ketamine, RO 25-6981 and the positive control, citalopram, were tested for antidepressant-like and anxiolytic-like effects in mice using the forced-swim test, the elevated zero maze and the novelty-induced hypophagia test...
February 2017: Behavioural Pharmacology
https://www.readbyqxmd.com/read/27739173/possible-involvements-of-glutamate-and-adrenergic-receptors-on-acute-toxicity-of-methylphenidate-in-isolated-hippocampus-and-cerebral-cortex-of-adult-rats
#15
Majid Motaghinejad, Manijeh Motevalian, Behnaz Shabab
Neurodegeneration induced by methylphenidate (MPH), as a central stimulant with unknown long-term consequences, in adult rats' brain and the possible mechanisms involved were studied. Rats were acutely treated with MPH in the presence and absence of some receptor antagonists such as ketamine, topiramate, yohimbine, and haloperidol. Motor activity and anxiety level in rats were monitored. Antioxidant and inflammatory parameters were also measured in isolated hippocampus and cerebral cortex. MPH-treated groups (10 and 20 mg/kg) demonstrated anxiety-like behavior and increased motor activity...
April 2017: Fundamental & Clinical Pharmacology
https://www.readbyqxmd.com/read/27734549/comparison-of-oral-midazolam-with-intranasal-dexmedetomidine-premedication-for-children-undergoing-ct-imaging-a-randomized-double-blind-and-controlled-study
#16
Babita Ghai, Kajal Jain, Akshay Kumar Saxena, Nidhi Bhatia, Kushaljit Singh Sodhi
BACKGROUND: Children undergoing computerized tomography (CT) frequently require sedation to allay their anxiety, and prevent motion artifacts and stress of intravenous (IV) cannulation. AIMS: The aim of this trial was to compare the effectiveness of oral midazolam and intranasal dexmedetomidine as sole premedicants in children for carrying out both IV cannulation as well as CT scanning, without the need for additional IV sedatives. METHODS: Fifty-nine children, aged 1-6 years, scheduled to undergo CT imaging under sedation were randomized to receive either 0...
January 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27703782/ketamine-stimulating-antidepressant-treatment
#17
EDITORIAL
Gin S Malhi, Yulisha Byrow, Frederick Cassidy, Andrea Cipriani, Koen Demyttenaere, Mark A Frye, Michael Gitlin, Sidney H Kennedy, Terence A Ketter, Raymond W Lam, Rupert McShane, Alex J Mitchell, Michael J Ostacher, Sakina J Rizvi, Michael E Thase, Mauricio Tohen
SUMMARY: The appeal of ketamine - in promptly ameliorating depressive symptoms even in those with non-response - has led to a dramatic increase in its off-label use. Initial promising results await robust corroboration and key questions remain, particularly concerning its long-term administration. It is, therefore, timely to review the opinions of mood disorder experts worldwide pertaining to ketamine's potential as an option for treating depression and provide a synthesis of perspectives - derived from evidence and clinical experience - and to consider strategies for future investigations...
May 2016: BJPsych Open
https://www.readbyqxmd.com/read/27623117/-clinical-and-biological-predictors-of-ketamine-response-in-treatment-resistant-major-depression-review
#18
B Romeo, W Choucha, P Fossati, J-Y Rotge
OBJECTIVE: The aim of this review was to determine the clinical and biological predictors of the ketamine response. METHODS: A systematic research on PubMed and PsycINFO database was performed without limits on year of publication. RESULTS: The main predictive factors of ketamine response, which were found in different studies, were (i) a family history of alcohol dependence, (ii) unipolar depressive disorder, and (iii) neurocognitive impairments, especially a slower processing speed...
September 9, 2016: L'Encéphale
https://www.readbyqxmd.com/read/27479259/-emergence-delirium-in-children-prophylaxis-and-treatment
#19
Julius Z Wermelt, Richard K Ellerkmann
Emergence Delirium in children after general anesthesia is a common and self limitating event. Although it might be seen as being harmless it can cause other serious complications and might leave both parents and other caregivers with a negative impression behind. Although the cause may still not be clear, potential predictors can be named: preschool age, the use of fast acting volatile anesthestics, higher preoperative anxiety levels and postoperative pain.A child-focused approach to reduce preoperative anxiety focusing on distraction methods rather than pharmacological sedation may be the key as well as sufficient postoperative pain control and the use of total intravenous anesthesia...
July 2016: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/27366520/effect-of-ketamine-thiopental-and-ketamine-thiopental-combination-during-electroconvulsive-therapy-for-depression
#20
Özlem Özkan Kuşçu, Feride Karacaer, Ebru Biricik, Ersel Güleç, Lut Tamam, Yasemin Güneş
OBJECTIVE: We aimed to evaluate the effect of anaesthesia with thiopental (4 mg kg(-1)), ketamine (1 mg kg(-1)) and ketamine-thiopental (1 mg kg(-1) and 4 mg kg(-1), respectively) combination during electroconvulsive therapy (ECT) on the Hamilton Depression Rating Scale (HDRS) and Hamilton Anxiety Rating Scale (HAM-A) and haemodynamic variables in patients with resistant major depression. METHODS: Patients with HDRS scores above 17 were included. The patients were randomly divided into three groups according to the anaesthesia used...
October 2015: Turkish Journal of Anaesthesiology and Reanimation
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