Ketamine intranasal

Sensory systems Blurred vision, vertigo, and noise intolerance have been reported as adverse reactions to intranasal ketamine [26 ]. 

The hi-dose delivery system for our intransal ketamine product candidate provides non-invasive (i.e. needle-free) administration compared to IV or IM injections, via a rugged, simple to use device that can be patient-administered if necessary. Each disposable device delivers a total of 30 mg ketamine with well-characterized, predictable pharmacokinetics. This approach to delivering subanesthetic doses of ketamine may be particularly advantageous in emergency situations where convenience, speed of drug delivery/onset, and avoidance of accidental needle sticks in healthcare providers are desirable. In addition, our intranasal ketamine product candidate was formulated to minimize neurotoxicity, a question that has been raised regarding the differently formulated ketamine product currently approved for anesthesia. 

Our intranasal ketamine product candidate is being developed for the management of acute moderate to severe pain, as well as BTP in patients on chronic opioid therapy. Pilot studies in both of these pain models, using the exploratory formulation of Ereska, have yielded encouraging results for safety and efficacy. A randomized, double-blind, singledose parallel study [3] tested 10, 30 and 50 mg IN... 

Table 110.1. Intranasal ketamine for acute pain after extraction of impacted molars TOTPAR scores across I and 3 hours (with...

Table 110.2. Intranasal ketamine decreased breakthrough pain in 20 patients on chronic (>6 weeks) opioid therapy (with...

In summary, subanesthetic doses of ketamine are now used increasingly in anesthesia practice as part of multimodal regimens for acute pain, as well as add-on therapy in selected patients with chronic pain. Our intranasal ketamine product candidate provides a simple, non-invasive alternative to the present invasive (IM, IV) methods of systemic administration of low-dose ketamine, and has the potential to make this agent available on a broader scale. However, it is still under development and the final assessment of its benefits and risks will await completion and integration of the results of its entire clinical investigative program. 

Christensen K, Rogers E, Green GA, Hamilton DA, Mermelstein F, liao E, Wright C, Carr DB. Safety and efficacy of intranasal ketamine for acute postoperative pain. Acute Pain 2007 9 183-192. 

Carr DB, Goudas LC, Denman WT, et al. Safety and efficacy of intranasal ketamine for the treatment of breakthrough pain in patients with chronic pain a randomized, double-blind, placebo-controlled, crossover study. Pain 2004 108 17-27. 

Afridi SK, Giffin NJ, Kaube H, Goadsby PJ. A randomized controlled trial of intranasal ketamine in migraine with prolonged aura. Neurology 2013 80 642-7. 

Andolfatto G, WiUman E, Joo D, Miller P, Wong WB, Koehn M, et al. Intranasal ketamine for analgesia in the emergency department a prospective observational series. Acad Emerg Med 2013 20 1050-4. 

Ketamine is a cyclohexane human and veterinary injectable anesthetic that is also known by the slang names K, special K, vitamin K, and cat Valium (Bobo and Miller 2002). It is produced in a liquid form or as a white powder and is usually ingested orally or intranasally but is occasionally administered intramuscularly. Ketamine is a phencyclidine (PCP) analog that was first developed in 1962. 

Kronenberg, R. H. Ketamine as an Analgesic Parenteral, Oral, Rectal, Subcutaneous, Transdermal and Intranasal Administration. Journal of Pain and Palliative Care Pharmacotherapy 16 (3) (2002) 27-35. 

Intranasal drug delivery This drug delivery provides fast and direct access to systemic circulation without first-pass metabolism. Administration is not easy especially with uncooperative children, but small volumes involved, rapidity of execution, feasibility at home has made it more attractive, particularly for no-needle approach to acute Illnesses. Aerosols with an appropriate device can avoid swallowing and is more precise in terms of dose. Drugs such as benzodiazepines, fentanyl, diamorphine, and ketamine have been used successfully via this route (90). 

Huge V, Lauchart M, Magerl W, Schelling G, Beyer A, Thieme D, Azad SC. Effects of low-dose intranasal (S)-ketamine in patients with neuropathic pain. Eur J Pain 2010 14 387-94. 

Generic Name ketamine hydrochloride (for intranasal administration)... 

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