Are statins beneficial for the treatment of SARS-CoV-2 infection?

Novel coronavirus disease 2019 (COVID-19) is a highly infectious, rapidly spreading viral disease and has emerged as a public health emergency of international concern. As of this time, there are no specific antiviral therapies available for the treatment of COVID-19. However, it is possible that some existing drugs, usually used for other conditions, may have some benefits. Statins have been widely reported to exert antiviral activity against many enveloped viruses by inhibiting the cholesterol biosynthesis pathway. Cholesterol likewise contributes to the coronavirus's life cycle, including viral entry, fusion and budding. In addition, statins have been ascribed beneficial anti-inflammatory, immunomodulatory effects and promote haemodynamic stability. Therefore, statins, which are cholesterol-lowering drugs with anti-inflammatory, immunomodulatory and antiviral properties, may play a role in SARS-CoV-2 therapy. The aim of the present minireview was to delineate the potential beneficial therapeutic effects of statins in treating SARS-CoV-2 infections. Nevertheless, large, randomised trials are needed to confirm the beneficial effects and safety profile of the statins in patients with SARS-CoV-2.

Low-Dose Ketamine for Postoperative Pain Management.

Ketamine, an anesthetic agent, is gaining attention as an analgesic for the management of acute and chronic pain conditions. Perianesthesia nurses may expect to see ketamine's use increase as more anecdotal and evidence-based experience is gained with its use for pain management. Unlike opioids, ketamine supports respirations while supporting hemodynamic function; moreover, the agent has potential for decreasing opioid-induced hyperalgesia. Ongoing clinical evidence continues to support ketamine's use for analgesia, thus it may be argued that the current Food and Drug Administration classification for ketamine as an anesthetic agent is outdated, and patients would be better served by a reclassification of this medication to include its use for analgesic purposes. This continuing education article provides an overview of ketamine, its side effects, and the possible adverse reactions so perianesthesia nurses may be prepared to care for postsurgical patients who receive ketamine for analgesic purposes.

Ketamine Infusions for Outpatient Pain Management: A Policy Development Project.

Current literature supports using ketamine for both acute and chronic pain management. It is imperative that the development of evidence-based protocols and policies keep pace with health care delivery to ensure patient safety. This project's objective was to formulate an outpatient ketamine infusion policy that promotes consistent and evidence-based care within a specified hospital system. This policy addresses potential side effects and minimization of adverse events by addressing patient selection, level of nursing care required, appropriate monitoring, and staff education.

Ketamine for Pain Management-Side Effects & Potential Adverse Events.

An old anesthetic agent, ketamine is finding new use in lower doses for analgesic purposes. There are concerns stemming from its potential side effects-specifically psychomimetic effects. These side effects are directly related to dose amount. The doses used for analgesic purposes are much lower than those used for anesthesia purposes. A literature review was performed to ascertain potential side effects and/or adverse events when using ketamine for analgesia purposes. The search included CINAHL, PubMed, and Ovid using the search terms "ketamine," "ketamine infusion," "pain," "adverse events," "practice guideline," and "randomized controlled trial." Searches were limited to full-text, peer-reviewed articles and systematic reviews. Initially 1,068 articles were retrieved. The search was then narrowed by using the Boolean connector AND with various search term combinations. After adjusting for duplication, article titles and abstracts were reviewed, leaving 25 articles for an in-depth analysis. Specific exclusion criteria were then applied. The literature supports the use of ketamine for analgesic purposes, and ketamine offers a nonopioid option for the management of some pain conditions. Because ketamine is still classified as an anesthetic agent, health care institutions should develop their own set of policies and protocols for the administration of ketamine. By using forethought and understanding of the properties of ketamine, appropriate care may be planned to mitigate potential side effects and adverse events so that patients are appropriately cared for and their pain effectively managed.