ABSTRACT
Initially known as CI-581, ketamine was first synthesized in 1962 as a replacement from phencyclidine. It has since been used as an anesthetic and analgesic. In addition, it has bronchodilating, sedative, and amnestic properties, preserving airway reflexes and sympathetic nervous system tone. Since the discovery of ketamine, it has been a major topic of discussion due to controversies regarding its usage in particular sets of patients. In the past 50 years, despite its potential benefits, it is not commonly used because of concerns of “emergence phenomenon,” its use as a substance of abuse, and its systemic side effects. Since 2012, three World Health Organization reviews on ketamine have addressed its international control.Researchers have been studying this wonder drug for a decade worldwide. Many myths of ketamine regarding emergence phenomenon and its use in traumatic brain injury and open eye injury have been disproved in recent times. It is becoming popular in pre-hospital settings, critical care, emergency medicine, low-dose acute pain services, and adjuvant in regional anesthesia techniques. This review highlights the current consensus on the various applications of ketamine in the literature.
ABSTRACT
Initially known as CI-581, ketamine was first synthesized in 1962 as a replacement from phencyclidine. It has since been used as an anesthetic and analgesic. In addition, it has bronchodilating, sedative, and amnestic properties, preserving airway reflexes and sympathetic nervous system tone. Since the discovery of ketamine, it has been a major topic of discussion due to controversies regarding its usage in particular sets of patients. In the past 50 years, despite its potential benefits, it is not commonly used because of concerns of “emergence phenomenon,” its use as a substance of abuse, and its systemic side effects. Since 2012, three World Health Organization reviews on ketamine have addressed its international control.Researchers have been studying this wonder drug for a decade worldwide. Many myths of ketamine regarding emergence phenomenon and its use in traumatic brain injury and open eye injury have been disproved in recent times. It is becoming popular in pre-hospital settings, critical care, emergency medicine, low-dose acute pain services, and adjuvant in regional anesthesia techniques. This review highlights the current consensus on the various applications of ketamine in the literature.
ABSTRACT
Background: Irrational prescribing of medicine results in serious morbidity and mortality as well as additional economic burden and also lead to reduction in the quality of treatment; thereby causing wastage of resources, increased treatment cost, increased risk for adverse drug reaction, and emergence of resistance. WHO has generated indicators in three main drug use areas; prescribing, patient care, and facility specific factors. Methods: This study was carried out with the aim of identifying prescription pattern of antibiotics and evaluates the rationality of prescriptions in accordance with WHO prescribing indicators. 300 prescriptions were examined from the inpatient department (IPD) of a tertiary care teaching hospital from the Department of Medicine, Surgery, and Orthopedics. The IPDs were visited twice a week. Each prescription was followed for the duration of 5 days. The prescribing and dispensing details from each prescription were recorded in a tabular form as mentioned in data acquisition form. The data were analyzed as per the WHO core drug use indicators. Results: This study clearly highlights the practice of polypharmacy, low uses of generic drugs, injudicious usage of antibiotic, and injection and low usage of the drug prescribed from essential drug list. Conclusions: Multi-faceted interventions are required at many levels for the benefits of the community in the form of continued medical educational programs, consumer awareness, formation of hospital formulary, and undergraduate clinical pharmacology and therapeutics teaching.