+ Site Statistics
References:
54,258,434
Abstracts:
29,560,870
PMIDs:
28,072,757
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Compounded oral ketamine



Compounded oral ketamine



International Journal of Pharmaceutical Compounding 16(5): 364-368



The nonnarcotic nonaddictive neuropathic pain reliever ketamine, which was synthesized in the early 1960s by Parke-Davis, was first administered to human patients in 1965. Used by the U. S. military as a field anesthetic during the Vietnam War, it slowly became popular as both an induction and maintenance agent for the general anesthesia required during brief surgical procedures. The use of ketamine in the past has been limited primarily to intravenous administration in hospitalized patients. Very recently, several published reports have described the use of low-dose ketamine for the relief of pain, refractory depression, and anxiety in patients with or without cancer. Because chronic pain, depression, and anxiety often occur in hospice patients with or without cancer and in palliative care patients who are not eligible for hospice, the discovery of new and effective uses for an established drug to treat those conditions has excited interest in the palliative care community. We support that interest with this case report, which describes our experience in treating a 44-year-old male hospice patient with severe constant anxiety, fear, and depression in addition to multiple near-terminal comorbid physical conditions that produce chronic pain. Prior treatments prescribed to resolve this patient's pain, anxiety, and depression had proven ineffective. However, a single low-dose (0.5 mg/kg) subcutaneous test injection of ketamine provided dramatic relief from those symptoms for 80 hours, although the anesthetic effects of that drug are not of long duration. This good outcome has been sustained to date by daily treatment with a compounded flavored oral ketamine solution (40 mg/5 mL) that is not commercially available. Flavoring the solution masks the bitter taste of ketamine and renders the treatment palatable. We found ketamine to be a well-tolerated and effective treatment for the triad of severe anxiety, chronic pain, and severe depression in a hospice patient with multiple comorbid conditions. To our knowledge, this report chronicles the first use of compounded oral ketamine for home-based palliative or hospice care in Louisiana. A formulation for a flavored oral ketamine solution is provided for easy reference.

Please choose payment method:






(PDF emailed within 1 workday: $29.90)

Accession: 052269294

Download citation: RISBibTeXText

PMID: 23072195


Related references

A comparison of oral midazolam, oral ketamine, and oral midazolam combined with ketamine as preanesthetic medication for pediatric outpatients. Anesthesiology 79(3A): A1177, 1993

Beyond-use dating of extemporaneously compounded ketamine, acepromazine, and xylazine: safety, stability, and efficacy over time. Journal of the American Association for Laboratory Animal Science 48(6): 718-726, 2010

Near fatal accidental transdermal overdose of compounded ketamine, baclofen, amitriptyline, lidocaine, and ketoprofen A case report. Journal of Toxicology Clinical Toxicology 41(5): 672, 2003

Rifampicin has a profound effect on the pharmacokinetics of oral S-ketamine and less on intravenous S-ketamine. Basic and Clinical Pharmacology and Toxicology 111(5): 325-332, 2013

Effects of Compounded Stanford Modified Oral Rinse (MucoLox) on the Survival and Migration of Oral Keratinocytes and Fibroblasts: Implications for Wound Healing. International Journal of Pharmaceutical Compounding 22(1): 60-65, 2018

Evaluation of the Percutaneous Absorption of Ketamine HCl, Gabapentin, Clonidine HCl, and Baclofen, in Compounded Transdermal Pain Formulations, Using the Franz Finite Dose Model. Pain Medicine 17(2): 230-238, 2017

A comparison study between ketamine and ketamine-promethazine combination for oral sedation in pediatric dental patients. Anesthesia Progress 49(1): 14-18, 2003

Low dose ketamine as an analgesic adjuvant in difficult pain syndromes: a strategy for conversion from parenteral to oral ketamine. Journal of Pain and Symptom Management 23(2): 165-170, 2002

Comparison of Isoflurane, Ketamine- Dexmedetomidine, and Ketamine-Xylazine for General Anesthesia during Oral Procedures in Rice Rats (Oryzomys palustris). Journal of the American Association for Laboratory Animal Science 2018, 2018

Use of xylazine/ketamine or medetomidine combined with either ketamine, ketamine/butorphanol, or ketamine/telazol for immobilization of white-tailed deer (Odocoileus virginianus). 2007

Sedating pediatric dental patients by oral ketamine with alternating bi-lateral stimulation of eye movement desensitization and minimizing adverse reaction of ketamine by acupuncture and Bi-Digital O-Ring Test. Acupuncture and Electro-Therapeutics Research 37(2-3): 103-123, 2013

Acceptability and compliance of atenolol tablet, compounded paste and compounded suspension prescribed to healthy cats*. Journal of Feline Medicine and Surgery 14(2): 99-106, 2012

Nifedipine in compounded oral and topical preparations. International Journal of Pharmaceutical Compounding 15(2): 166-169, 2011

Stability of compounded thioguanine oral suspensions. American Journal of Health-System Pharmacy 68(10): 900-908, 2011

Oral preanaesthetic medication for children: double-blind randomized study of a combination of midazolam and ketamine vs midazolam or ketamine alone. British Journal of Anaesthesia 84(3): 335-340, 2000