Ketamine - Reves Et Realites

Arditti, Joyce A.; Spadari, Michel; Haro, Luc de; Brun, Anne; Bourdon, J; Valli, M

doi:10.1179/acb.2002.073

Cited by 12 publications

(5 citation statements)

References 16 publications

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“…Whereas the acute psychotropic effects of ketamine may cause discomfort for some individuals (Domino et al, 1965), its dissociative properties have made it desirable for recreational use (Siegel, 1978;Stewart, 2001). However, some users may experience increased agitation or anxiety/panic attacks (Siegel, 1978;Jansen, 2000;Weiner et al, 2000;Arditti et al, 2002). Within 10 minutes following initiation of a 40-minute i.v.…”

Section: Clinical Effectsmentioning

confidence: 99%

“…), 50 and 150 mg (i.m. ), 100 and 500 mg (oral), or 30 and 400 mg (intranasal insufflation; Siegel, 1978;Dalgarno and Shewan, 1996;Jansen, 2000;Arditti et al, 2002;Wolff and Winstock, 2006;Bokor and Anderson, 2014). Although the effects of specific doses used for recreational use cannot be directly determined due to a lack of controlled studies assessing these, users report that lower doses induce mild stimulatory, dissociative, and hallucinogenic effects, whereas higher doses yield psychotomimetic symptoms and separation from reality (Stewart, 2001;Wolff and Winstock, 2006).…”

Section: Clinical Effectsmentioning

confidence: 99%

See 1 more Smart Citation

Ketamine and Ketamine Metabolite Pharmacology: Insights into Therapeutic Mechanisms

et al. 2018

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Ketamine, a racemic mixture consisting of ()- and ()-ketamine, has been in clinical use since 1970. Although best characterized for its dissociative anesthetic properties, ketamine also exerts analgesic, anti-inflammatory, and antidepressant actions. We provide a comprehensive review of these therapeutic uses, emphasizing drug dose, route of administration, and the time course of these effects. Dissociative, psychotomimetic, cognitive, and peripheral side effects associated with short-term or prolonged exposure, as well as recreational ketamine use, are also discussed. We further describe ketamine's pharmacokinetics, including its rapid and extensive metabolism to norketamine, dehydronorketamine, hydroxyketamine, and hydroxynorketamine (HNK) metabolites. Whereas the anesthetic and analgesic properties of ketamine are generally attributed to direct ketamine-induced inhibition of -methyl-D-aspartate receptors, other putative lower-affinity pharmacological targets of ketamine include, but are not limited to, γ-amynobutyric acid (GABA), dopamine, serotonin, sigma, opioid, and cholinergic receptors, as well as voltage-gated sodium and hyperpolarization-activated cyclic nucleotide-gated channels. We examine the evidence supporting the relevance of these targets of ketamine and its metabolites to the clinical effects of the drug. Ketamine metabolites may have broader clinical relevance than was previously considered, given that HNK metabolites have antidepressant efficacy in preclinical studies. Overall, pharmacological target deconvolution of ketamine and its metabolites will provide insight critical to the development of new pharmacotherapies that possess the desirable clinical effects of ketamine, but limit undesirable side effects.

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Section: Clinical Effectsmentioning

confidence: 99%

Section: Clinical Effectsmentioning

confidence: 99%

Ketamine and Ketamine Metabolite Pharmacology: Insights into Therapeutic Mechanisms

et al. 2018

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“…the sensation of floating or flying, looking down on their body from above and seeing flowers, etc. [13]. This study suggests that a minimum dose of 0.1 mg.kg −1 diazepam is required to significantly reduce dreaming compared with water and that increasing the dose further produces no extra benefit.…”

Section: Discussionmentioning

confidence: 93%

The effect of variable‐dose diazepam on dreaming and emergence phenomena in 400 cases of ketamine‐fentanyl anaesthesia

Grace

2003

Anaesthesia

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SummaryWe developed a screening questionnaire to be used by nurses to decide which patients should see an anaesthetist for further evaluation before the day of surgery. Our objective was to measure the accuracy of responses to the questionnaire. Agreement between questionnaire responses and the anaesthetist's assessment was assessed. For questions with a prevalence of 5 to 95%, the Kappa coefficient was used; percentage agreement was used for all other questions. Criterion validity was excellent ⁄ good for all questions with a prevalence between 5 and 95%, except for the question 'Do you have kidney disease?' For questions with prevalence < 5%, all demonstrated adequate criterion validity except the questions 'Has anyone in your family had a problem following an anaesthetic?' and 'If you have been put to sleep for an operation were there any anaesthetic problems?' Therefore, it is reasonable for nurses to use this questionnaire to determine which patients an anaesthetist should see before the day of surgery.Keywords Anaesthesia; pre-operative, assessment, questionnaire. Recent advances in anaesthetic and surgical practice have facilitated the growth of 'fast track' surgery [1, 2]. Careful outpatient assessment is fundamental to the success of this type of surgery and the Association of Anaesthetists of Great Britain and Ireland now recommends assessment at a pre-operative assessment (POA) clinic [3].The provision of a pre-operative screening and assessment service at POA clinics supplies background information about patient's general medical status and fitness for anaesthesia. POA clinics improve patient care by allowing careful pre-operative evaluation and optimisation of coexisting disease [4], reduce costs [5, 6], improve efficiency [7], and lower surgical cancellation rates [8, 9].In POA clinics, nurses increasingly carry out preoperative screening [10]. Although they are not qualified to decide if a patient is fit for anaesthesia, they play a valuable role in identifying patients who are at risk and require further evaluation and optimisation before the day of surgery [11]. Nurses screen patients for risk factors for fitness for anaesthesia and surgery using questionnaires [12]. These can be self-administered by the patient [9], or used during structured interviews [13], or computer programs [14]. Although many locally developed questionnaires exist, few have been formally assessed.We have developed a multi-tiered screening questionnaire to be used by nurses to decide which patients should be seen at a POA clinic by an anaesthetist for further evaluation and optimisation. Using Delphi consensus methods, we have already evaluated content validity for each question [15] to ensure that the questions are relevant to concept being measured.Our objective was to perform item analysis of the screening questionnaire and measure criterion validity [16], that is, is it a true measure of what it is designed to measure?By testing individual questions beyond basic content validity, we were able to put them together in a...

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“…Today, ketamine is commonly not only used in the emergency medicine setting of intubation and procedural sedation, but also has gained wide recognition as a recreational drug where users can develop hallucinations, floating sensations, and dissociation [1,2]. Ketamine, also known as 2-chlorophenyl-2-methylamino-cyclohexanone, is structurally related to phencyclidine [3]. It is a non-competitive antagonist of the N-methyl-Daspartate (NMDA) receptor [4].…”

Section: Introductionmentioning

confidence: 99%

The Special K Constellation, a Rare Presentation of Ketamine Use: A Case Report

Williams

Hsu

Flamer-Caldera³

et al. 2019

Cureus

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Ketamine is commonly used in the emergency medicine setting, but also as a recreational drug. There have been many animal studies investigating ketamine, but little data on long-term clinical use of ketamine in humans. In this case presentation, a 22-year-old international male student presented with crepitus and cachexia and was found to have extensive subcutaneous emphysema, pneumorrhachis/intraspinal air, pneumomediastinum, and multiorgan failure. In this case report, we discuss how ketamine abuse is the likely cause of these findings.

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Ketamine - Reves Et Realites

Cited by 12 publications

References 16 publications

Ketamine and Ketamine Metabolite Pharmacology: Insights into Therapeutic Mechanisms

Ketamine and Ketamine Metabolite Pharmacology: Insights into Therapeutic Mechanisms

The effect of variable‐dose diazepam on dreaming and emergence phenomena in 400 cases of ketamine‐fentanyl anaesthesia

The Special K Constellation, a Rare Presentation of Ketamine Use: A Case Report

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