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Oral ketamine

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https://www.readbyqxmd.com/read/29295971/special-k-with-no-license-to-kill-accidental-ketamine-overdose-on-induction-of-general-anesthesia
#1
Lindsay L Warner, Nathan Smischney
BACKGROUND Ketamine is used as an induction and sedation agent in emergency departments and operating rooms throughout the country. Despite its widespread clinical use, there are few cases of significant morbidity and mortality attributed to ketamine overdose in the clinical setting. CASE REPORT The anesthesia provider in the room was an oral maxillofacial surgeon who inadvertently took out a more highly concentrated bottle of ketamine that is typically used for pediatric patients. The patient received 950 mg (100 mg/ml concentration) of intravenous ketamine instead of the intended 95 mg (10 mg/ml concentration)...
January 3, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29229209/randomized-double-blind-placebo-controlled-dose-escalation-study-investigation-of-the-safety-pharmacokinetics-and-antihyperalgesic-activity-of-l-4-chlorokynurenine-in-healthy-volunteers
#2
Mark Wallace, Alexander White, Kathy A Grako, Randal Lane, Allen Jo Cato, H Ralph Snodgrass
BACKGROUND AND AIMS: Neuropathic pain is a significant medical problem needing more effective treatments with fewer side effects. Overactive glutamatergic transmission via N-methyl-d-aspartate receptors (NMDARs) are known to play a role in central sensitization and neuropathic pain. Although ketamine, a NMDAR channel-blocking antagonist, is often used for neuropathic pain, its side-effect profile and abusive potential has prompted the search for a safer effective oral analgesic. A novel oral prodrug, AV-101 (l-4 chlorokynurenine), which, in the brain, is converted into one of the most potent and selective GlyB site antagonists of the NMDAR, has been demonstrated to be active in animal models of neuropathic pain...
October 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29223560/the-relationship-between-intestinal-and-oral-mucosa-microcirculation-in-anaesthetized-horses
#3
Klaus Hopster, Stephan Neudeck, Liza Wittenberg-Voges, Sabine Br Kästner
OBJECTIVE: To compare alteration in intestinal blood flow in anaesthetized horses with changes in oral mucosa blood flow. STUDY DESIGN: Prospective, randomized clinical study. ANIMALS: Eight warmblood horses. METHODS: After induction with guaifenesin and ketamine, anaesthesia was maintained with isoflurane at 1.5 vol% in oxygen. The tissue blood flow was measured using laser Doppler flowmetry at the jejunum, colon, rectal mucosa, oesophageal mucosa and the oral mucosa...
August 18, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/29191019/affinity-of-ketamine-to-clinically-relevant-transporters
#4
Markus Keiser, Mahmoud Hasan, Stefan Oswald
Ketamine is a widely used intravenous anaesthetic drug that has also a pronounced analgesic effect. Moreover, one of its metabolites was very recently shown to possess antidepressant activity. Consequently, oral administration of ketamine may become of interest in the future. There is evidence from in vitro data, drug-drug interactions and from the physicochemical properties of the drug that ketamine may be a substrate of drug transporters. Thus, it was the aim of this study to investigate the affinity of ketamine to clinically relevant transporter proteins that are expected to affect its intestinal absorption, distribution and excretion...
November 30, 2017: Molecular Pharmaceutics
https://www.readbyqxmd.com/read/29187151/pediatric-premedication-a-double-blind-randomized-trial-of-dexmedetomidine-or-ketamine-alone-versus-a-combination-of-dexmedetomidine-and-ketamine
#5
Hui Qiao, Zhi Xie, Jie Jia
BACKGROUND: Preoperative anxiety is common in pediatric patients. When dexmedetomidine is used alone for sedation as premedication, children tend to awaken when separated from their parents, and body movements occur during invasive procedures. We tested the hypothesis that the combination of dexmedetomidine and ketamine may be a useful premedication to alleviate preoperative anxiety and improve cooperation during intravenous cannulation in pediatric patients, while producing minimal adverse events...
November 29, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/29151192/impact-of-oral-ketamine-augmentation-on-hospital-admissions-in-treatment-resistant-depression-and-ptsd-a-retrospective-study
#6
John Hartberg, Simone Garrett-Walcott, Angelo De Gioannis
RATIONALE: Depressive episodes are the leading cause of mental health-related hospital admissions in Australia, and 44% of those admitted have a previous history of hospitalisations for depression (Admitted patient mental health-related care: (Australian Institute of Health and Welfare Aust Hospital Stat 2011-12, 2013). Despite numerous available antidepressant treatments, many patients do not respond to conventional therapy, having what is called 'treatment resistance' (Fava Biol Psychiatry 53:649-659, 2003)...
November 18, 2017: Psychopharmacology
https://www.readbyqxmd.com/read/29137881/comparison-between-chloral-hydrate-and-propofol-ketamine-as-sedation-regimens-for-pediatric-auditory-brainstem-response-testing
#7
Kamal Abulebda, Vinit J Patel, Sheikh S Ahmed, Alvaro J Tori, Riad Lutfi, Samer Abu-Sultaneh
INTRODUCTION: The use of diagnostic auditory brainstem response testing under sedation is currently the "gold standard" in infants and young children who are not developmentally capable of completing the test. OBJECTIVE: The aim of the study is to compare a propofol-ketamine regimen to an oral chloral hydrate regimen for sedating children undergoing auditory brainstem response testing. METHODS: Patients between 4 months and 6 years who required sedation for auditory brainstem response testing were included in this retrospective study...
October 28, 2017: Brazilian Journal of Otorhinolaryngology
https://www.readbyqxmd.com/read/29043601/pupillary-reflex-dilation-in-response-to-incremental-nociceptive-stimuli-in-patients-receiving-intravenous-ketamine
#8
Nada Sabourdin, Thomas Giral, Risa Wolk, Nicolas Louvet, Isabelle Constant
Pupillometry is a non-invasive monitoring technique, which allows dynamic pupillary diameter measurement by an infrared camera. Pupillary diameter increases in response to nociceptive stimuli. In patients anesthetized with propofol or volatile agents, the magnitude of this pupillary dilation is related to the intensity of the stimulus. Pupillary response to nociceptive stimuli has never been studied under ketamine anesthesia. Our objective was to describe pupillary reflex dilation after calibrated tetanic stimulations in patients receiving intravenous ketamine...
October 17, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29034354/prefrontal-connectivity-and-glutamate-transmission-relevance-to-depression-pathophysiology-and-ketamine-treatment
#9
Chadi G Abdallah, Christopher L Averill, Ramiro Salas, Lynnette A Averill, Philip R Baldwin, John H Krystal, Sanjay J Mathew, Daniel H Mathalon
BACKGROUND: Prefrontal global brain connectivity with global signal regression (GBCr) was proposed as a robust biomarker of depression, and was associated with ketamine's mechanism of action. Here, we investigated prefrontal GBCr in treatment-resistant depression (TRD) at baseline and following treatment. Then, we conducted a set of pharmacological challenges in healthy subjects to investigate the glutamate neurotransmission correlates of GBCr. METHODS: In study A, we used functional magnetic resonance imaging (fMRI) to compare GBCr between 22 TRD and 29 healthy control...
October 2017: Biological Psychiatry: Cognitive Neuroscience and Neuroimaging
https://www.readbyqxmd.com/read/29025089/oral-ketamine-for-acute-pain-management-after-amputation-surgery
#10
Asokumar Buvanendran, Jeffrey S Kroin, Arvind Rajagopal, Sherry J Robison, Mario Moric, Kenneth J Tuman
Objective: Intravenous ketamine has been shown to provide postoperative analgesia in many clinical trials, in particular to reduce opioid consumption. The primary objective of this pilot study is to determine if multiple dosing over a three-day perioperative period with oral ketamine is a safe treatment method for acute pain after amputation surgery. Methods: Three consented subjects (age 57-60 years) undergoing elective amputation of the lower extremity were included in the study (Institutional Review Board and Food and Drug Administration Investigational New Drug approved)...
September 14, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28959664/neuropharmacological-profile-and-chemical-analysis-of-fresh-rhizome-essential-oil-of-curcuma-longa-turmeric-cultivated-in-southwest-nigeria
#11
Idris A Oyemitan, Christianah A Elusiyan, Ayoola O Onifade, Moses A Akanmu, Adebola O Oyedeji, Armando G McDonald
BACKGROUND: Curcuma longa (turmeric) is commonly used as spice and also used to treat fever, cough and febrile convulsions in Nigeria. This study determined the chemical composition of the essential oil of C. longa and evaluated its neuropharmacological activity in mice. METHODS: Essential oil of C. longa (EOCL) fresh rhizome was obtained by hydrodistillation and its chemical composition determined by GC-MS. Acute toxicity (LD50) profile of the essential oil was determined orally (p...
2017: Toxicology Reports
https://www.readbyqxmd.com/read/28942680/brain-targeted-oral-delivery-of-doxycycline-hydrochloride-encapsulated-tween-80-coated-chitosan-nanoparticles-against-ketamine-induced-psychosis-behavioral-biochemical-neurochemical-and-histological-alterations-in-mice
#12
Monu Yadav, Milind Parle, Nidhi Sharma, Sameer Dhingra, Neha Raina, Deepak Kumar Jindal
To develop statistically optimized brain targeted Tween 80 coated chitosan nanoparticulate formulation for oral delivery of doxycycline hydrochloride for the treatment of psychosis and to evaluate its protective effect on ketamine induced behavioral, biochemical, neurochemical and histological alterations in mice. 3(2) full factorial design was used to optimize the nanoparticulate formulation to minimize particle size and maximize entrapment efficiency, while independent variables chosen were concentration of chitosan and Tween 80...
November 2017: Drug Delivery
https://www.readbyqxmd.com/read/28928558/oral-clonidine-premedication-attenuates-hemodynamic-responses-of-ketamine-during-total-intravenous-anesthesia
#13
Pulak Tosh, Sunil Rajan, Nitu Puthenveettil, Lakshmi Kumar
BACKGROUND: The most commonly used drug for total intravenous anesthesia (TIVA) is ketamine which results in cardiovascular stimulation. AIMS: The primary aim of this study was to assess the effect of oral clonidine premedication on attenuating the hemodynamic responses following ketamine administration. SETTINGS AND DESIGNS: This was a prospective, observational, comparative study conducted in a tertiary care institution. SUBJECTS AND METHODS: A total of 40 female patients aged 18-55 years who were posted for elective short gynecological procedures under TIVA were recruited for this study...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28835456/systematic-review-of-pharmacological-therapies-for-the-management-of-ischaemic-pain-in-patients-with-non-reconstructable-critical-limb-ischaemia
#14
REVIEW
Áine Ní Laoire, Fliss E M Murtagh
BACKGROUND: Critical limb ischaemia (CLI) is a severe manifestation of peripheral arterial disease, characterised by chronic ischaemic rest pain, ulcers or gangrene. Management of ischaemic pain is challenging in patients with no options for revascularisation and optimal pharmacological therapies have not been established. OBJECTIVES: To identify and evaluate the effectiveness of pharmacological therapies to treat ischaemic pain secondary to non-reconstructable CLI...
August 23, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28822616/the-garcinia-kola-biflavonoid-kolaviron-attenuates-experimental-hepatotoxicity-induced-by-diclofenac
#15
Quadri Kunle Alabi, Rufus Ojo Akomolafe, Olaoluwa Sesan Olukiran, Wale Johnson Adeyemi, Aliyat Olajumoke Nafiu, Modinat Adebukola Adefisayo, Joseph Gbenga Omole, Deborah Ifeoluwa Kajewole, Oluwole Olaniyi Odujoko
This study sought to investigate the effects of kolaviron on diclofenac-induced hepatotoxicity in rats. Sixty male Wistar rats were divided into 6 groups of 10 rats each as follows: a control group that received oral propylene glycol and treatment groups that received diclofenac alone, diclofenac followed by Livolin Forte (a reference drug), or diclofenac followed by kolaviron at three different doses. At the end of the study period, five rats per group were sacrificed under ketamine hydrochloride anesthetic, 24h after treatment, while the other 5 rats in the group were allowed to recover for 2 weeks before being sacrificed...
August 16, 2017: Pathophysiology: the Official Journal of the International Society for Pathophysiology
https://www.readbyqxmd.com/read/28749092/ketamine-for-depression-4-in-what-dose-at-what-rate-by-what-route-for-how-long-and-at-what-frequency
#16
REVIEW
Chittaranjan Andrade
BACKGROUND: Ketamine, administered in subanesthetic doses, is an effective off-label treatment for severe and even treatment-refractory depression; however, despite dozens of studies across nearly 2 decades of research, there is no definitive guidance on matters related to core practice issues. METHODS: This article presents a qualitative review and summary about what is known about ketamine dosing, rate of administration, route of administration, duration of treatment, and frequency of sessions...
July 2017: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/28748374/alterations-in-amino-acid-levels-in-mouse-brain-regions-after-adjunctive-treatment-of-brexpiprazole-with-fluoxetine-comparison-with-r-ketamine
#17
Min Ma, Qian Ren, Yuko Fujita, Chun Yang, Chao Dong, Yuta Ohgi, Takashi Futamura, Kenji Hashimoto
RATIONALE: Brexpiprazole, a serotonin-dopamine activity modulator, is approved in the USA as an adjunctive therapy to antidepressants for treating major depressive disorders. Similar to the N-methyl-D-aspartate receptor (NMDAR) antagonist ketamine, the combination of brexpiprazole and fluoxetine has demonstrated antidepressant-like effects in animal models of depression. OBJECTIVES: The present study was conducted to examine whether the combination of brexpiprazole and fluoxetine could affect the tissue levels of amino acids [glutamate, glutamine, γ-aminobutyric acid (GABA), D-serine, L-serine, and glycine] that are associated with NMDAR neurotransmission...
November 2017: Psychopharmacology
https://www.readbyqxmd.com/read/28742427/a-comparison-of-multimodal-analgesic-approaches-in-institutional-enhanced-recovery-after-surgery-protocols-for-colorectal-surgery-pharmacological-agents
#18
Erik M Helander, Michael P Webb, Meghan Bias, Edward E Whang, Alan D Kaye, Richard D Urman
INTRODUCTION: Enhanced Recovery After Surgery (ERAS®) protocols are the cornerstone of improved recovery after colorectal surgery. Their implementation leads to reduced morbidity and shorter hospital stays while attenuating the surgical stress response. Multimodal analgesia is an important part of ERAS protocols. We compared and contrasted protocols from 15 institutions to test our hypothesis that there is a fundamental consensus among them. MATERIALS AND METHODS: ERAS protocols for open and laparoscopic colorectal surgery were compared from 15 different healthcare facilities...
September 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28730132/investigation-of-efficacy-of-lidocaine-spray-for-sedated-esophagogastroduodenoscopy-in-children
#19
Ahmet Basturk, Reha Artan, Aygen Yılmaz
PURPOSE: Our aim in this study is to investigate efficacy of topical lidocaine spray for sedated esophagogastroduodenoscopy (EGD) in children. METHODS: The endoscopy of children aged between 3-18 years who underwent EGD in our endoscopy unit. Intravenous (IV) midazolam and ketamine were used for sedation. Prior to sedation, endoscopy nurse applied topical lidocaine 10% with pump spray at 1 mg/kg dose in group 1, and distilled water via identically scaled pump spray in group 2, in a double blinded fashion...
June 2017: Pediatric Gastroenterology, Hepatology & Nutrition
https://www.readbyqxmd.com/read/28707454/interventions-for-postoperative-pain-in-children-an-overview-of-systematic-reviews
#20
REVIEW
Krste Boric, Svjetlana Dosenovic, Antonia Jelicic Kadic, Marijan Batinic, Marija Cavar, Marjan Urlic, Nikolina Markovina, Livia Puljak
The aim of this study was to conduct an overview of systematic reviews that summarizes the results about efficacy and safety from randomized controlled trials involving the various strategies used for postoperative pain management in children. We searched the Cochrane Database of Systematic Reviews, CINAHL, Database of Reviews of Effect, Embase, MEDLINE, and PsycINFO from the earliest date to January 24, 2016. This overview included 45 systematic reviews that evaluated interventions for postoperative pain in children...
September 2017: Paediatric Anaesthesia
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