Adjunctive Use of Ketamine for Benzodiazepine-Resistant Severe Alcohol Withdrawal: a Retrospective Evaluation

Journal of Medical Toxicology : Official Journal of the American College of Medical Toxicology
Poorvi ShahTheodore Toerne

Abstract

Benzodiazepine (BZD)-resistant alcohol withdrawal remains a challenge for most institutions due to limited evidence with available agents. One published study currently exists utilizing the N-methyl-D-aspartate antagonist, ketamine, for alcohol withdrawal. The purpose of our study was to evaluate the effect of adjunctive ketamine continuous infusion on symptom control and lorazepam infusion requirements for BZD-resistant alcohol withdrawal patients in the intensive care unit. A retrospective review was conducted of patients receiving ketamine adjunctively with a lorazepam infusion for severe alcohol withdrawal between August 2012 and August 2014. Outcomes included time to symptom control, lorazepam infusion requirements, ketamine initial and maximum daily infusion rates, and adverse effects of ketamine. Thirty patients were included in the analysis. Mean time to initiation of ketamine after the initiation of a lorazepam infusion was 41.4 h. All patients achieved initial symptom control within 1 h of ketamine initiation. Median initial ketamine infusion rate was 0.75 mg/kg/h and the average maximum daily rate was 1.6 mg/kg/h. Significant decreases in lorazepam infusion rates from baseline were observed at 24 h (- 4 mg/h; p = 0.0...Continue Reading

References

Jun 1, 1979·The American Journal of Psychiatry·E Woo, D J Greenblatt
Mar 1, 1988·Critical Care Medicine·W C LineaweaverD N Hing
Aug 1, 1987·Annals of Emergency Medicine·G P YoungR H Dailey
Apr 1, 1985·Critical Care Medicine·K B Nolop, A Natow
Feb 15, 2001·Journal of Biomedical Science·K M Davis, J Y Wu
Dec 20, 2003·Annals of the New York Academy of Sciences·John H KrystalD Cyril D'Souza
Aug 28, 2010·Critical Care Medicine·MaryClare Sarff, Jeffrey A Gold
May 25, 2012·Annals of Intensive Care·Samuel G RaynerUNKNOWN Study Institution
Sep 25, 2012·Critical Care Clinics·Richard W CarlsonShivaramaiah Shashikumar
Dec 19, 2012·European Journal of Emergency Medicine : Official Journal of the European Society for Emergency Medicine·Jukka TolonenVeli-Pekka Harjola
Dec 28, 2012·Critical Care Medicine·Juliana BarrUNKNOWN American College of Critical Care Medicine
Feb 2, 2013·Epilepsy Research·Andrea S SynowiecKevin M Kelly
Oct 18, 2014·The Annals of Pharmacotherapy·Adrian WongSandra L Kane-Gill
Feb 25, 2015·Journal of Emergencies, Trauma, and Shock·Ben-Paul UmunnaErik Kulstad
Apr 18, 2015·Anesthesia, Essays and Researches·Madhuri S KurdiRadhika S Deva
May 20, 2015·Journal of Research in Pharmacy Practice·Deepa Kameswari PerumalMeher Ali Raja Mohammed
May 20, 2016·Pharmacotherapy·Deepali DixitMarilyn N Bulloch
Sep 3, 2016·Acta Neurologica Scandinavica·S JesseA C Ludolph
Nov 4, 2017·The International Journal of Neuropsychopharmacology·Thomas LiebeMartin Walter

❮ Previous
Next ❯

Citations

Aug 25, 2020·Critical Care Nursing Quarterly·Stephanie BaltajiTariq Cheema
Apr 23, 2020·Critical Care Medicine·Kimberly P HurthKevin M Wohlfarth
Apr 8, 2020·Open Access Emergency Medicine : OAEM·Chelsea WolfScott A Simpson
Apr 14, 2020·Expert Opinion on Pharmacotherapy·A GlahnT Hillemacher
Jan 12, 2022·Journal of Psychopharmacology·Alessio CittadiniVanni Agnoletti

❮ Previous
Next ❯

Methods Mentioned

BETA
sedation

Software Mentioned

Ar
CIWA

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.