Dependencia a ketamina en un anestesiólogo. ¿Riesgo ocupacional?
Ketamine dependence in an anesthesiologist: an occupational hazard?
Goyal S, Ambekar A, Ray R.
Indian J Psychol Med. 2014 Jul;36(3):335-7. doi: 10.4103/0253-7176.135395.
Abstract
Substance abuse among medical professionals is a cause for concern. Certain psychotropic substances such as ketamine are at easy dispense to anesthesiologists increasing the likelihood of misuse and dependence and raise several issues including safety of patients. We discuss a case demonstrating ketamine dependence in an anesthesiologist from India. The reported psychotropic effects of ketamine ranged from dissociation and depersonalization to psychotic experiences. There was also development of significant tolerance to ketamine without prominent physical withdrawal symptoms and cyclical use of very high doses was observed. Issues related to management of health professionals are also discussed.
KEYWORDS: Anesthesiologist; ketamine; medical professionals
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4100428/
Usarla o no. Actualización sobre el uso legal e ilegal de ketamina
To use or not to use: an update on licit and illicit ketamine use.
Li JH, Vicknasingam B, Cheung YW, Zhou W, Nurhidayat AW, Jarlais DC, Schottenfeld R.
Subst Abuse Rehabil. 2011 Mar 16;2:11-20. doi: 10.2147/SAR.S15458. eCollection 2011.
Abstract
Ketamine, a derivative of phencyclidine that was developed in the 1960s, is an anesthetic and analgesic with hallucinogenic effects. In this paper, the pharmacological and toxicological effects of ketamine are briefly reviewed. Ketamine possesses a wide safety margin but such a therapeutic benefit is somewhat offset by its emergence phenomenon (mind-body dissociation and delirium) and hallucinogenic effects. The increasing abuse of ketamine, initially predominantly in recreational scenes to experience a "k-hole" and other hallucinatory effects but more recently also as a drug abused during the workday or at home, has further pushed governments to confine its usage in many countries. Recently, urinary tract dysfunction has been associated with long-term ketamine use. In some long-term ketamine users, such damage can be irreversible and could result in renal failure and dialysis. Although ketamine has not yet been scheduled in the United Nations Conventions, previous studies using different assessment parameters to score the overall harms of drugs indicated that ketamine may cause more harm than some of the United Nations scheduled drugs. Some countries in Southeast and East Asia have reported an escalating situation of ketamine abuse. Dependence, lower urinary tract dysfunction, and sexual impulse or violence were the most notable among the ketamine-associated symptoms in these countries. These results implied that the danger ofketamine may have been underestimated previously. Therefore, the severity levels of the ketamine-associated problems should be scrutinized more carefully and objectively. To prevent ketamine from being improperly used and evolving into an epidemic, a thorough survey on the prevalence and characteristics of illicit ketamine use is imperative so that suitable policy and measures can be taken. On the other hand, recent findings thatketamine could be useful for treating major depressive disorder has given this old drug a new impetus. If ketamine is indeed a remedy for treating depression, more research on the risks and benefits of its clinical use will be indispensable.
KEYWORDS: anti-depressant; cognitive impairment; epidemiology; ketamine; psychedelic effects; urinary tract dysfunction
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3846302/pdf/sar-2-011.pdf
Ketamina. OMS 2012
Ketamine. Expert peer review on critical review report (1). 35th Expert Committee on Drug Dependence, Hammamet, Tunisia
June 4-8, 2012, WHO
http://www.who.int/medicines/areas/quality_safety/4.2.1ExpertreviewKetaminecriticalreview.pdf
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
Ketamine dependence in an anesthesiologist: an occupational hazard?
Goyal S, Ambekar A, Ray R.
Indian J Psychol Med. 2014 Jul;36(3):335-7. doi: 10.4103/0253-7176.135395.
Abstract
Substance abuse among medical professionals is a cause for concern. Certain psychotropic substances such as ketamine are at easy dispense to anesthesiologists increasing the likelihood of misuse and dependence and raise several issues including safety of patients. We discuss a case demonstrating ketamine dependence in an anesthesiologist from India. The reported psychotropic effects of ketamine ranged from dissociation and depersonalization to psychotic experiences. There was also development of significant tolerance to ketamine without prominent physical withdrawal symptoms and cyclical use of very high doses was observed. Issues related to management of health professionals are also discussed.
KEYWORDS: Anesthesiologist; ketamine; medical professionals
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4100428/
Usarla o no. Actualización sobre el uso legal e ilegal de ketamina
To use or not to use: an update on licit and illicit ketamine use.
Li JH, Vicknasingam B, Cheung YW, Zhou W, Nurhidayat AW, Jarlais DC, Schottenfeld R.
Subst Abuse Rehabil. 2011 Mar 16;2:11-20. doi: 10.2147/SAR.S15458. eCollection 2011.
Abstract
Ketamine, a derivative of phencyclidine that was developed in the 1960s, is an anesthetic and analgesic with hallucinogenic effects. In this paper, the pharmacological and toxicological effects of ketamine are briefly reviewed. Ketamine possesses a wide safety margin but such a therapeutic benefit is somewhat offset by its emergence phenomenon (mind-body dissociation and delirium) and hallucinogenic effects. The increasing abuse of ketamine, initially predominantly in recreational scenes to experience a "k-hole" and other hallucinatory effects but more recently also as a drug abused during the workday or at home, has further pushed governments to confine its usage in many countries. Recently, urinary tract dysfunction has been associated with long-term ketamine use. In some long-term ketamine users, such damage can be irreversible and could result in renal failure and dialysis. Although ketamine has not yet been scheduled in the United Nations Conventions, previous studies using different assessment parameters to score the overall harms of drugs indicated that ketamine may cause more harm than some of the United Nations scheduled drugs. Some countries in Southeast and East Asia have reported an escalating situation of ketamine abuse. Dependence, lower urinary tract dysfunction, and sexual impulse or violence were the most notable among the ketamine-associated symptoms in these countries. These results implied that the danger ofketamine may have been underestimated previously. Therefore, the severity levels of the ketamine-associated problems should be scrutinized more carefully and objectively. To prevent ketamine from being improperly used and evolving into an epidemic, a thorough survey on the prevalence and characteristics of illicit ketamine use is imperative so that suitable policy and measures can be taken. On the other hand, recent findings thatketamine could be useful for treating major depressive disorder has given this old drug a new impetus. If ketamine is indeed a remedy for treating depression, more research on the risks and benefits of its clinical use will be indispensable.
KEYWORDS: anti-depressant; cognitive impairment; epidemiology; ketamine; psychedelic effects; urinary tract dysfunction
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3846302/pdf/sar-2-011.pdf
Ketamina. OMS 2012
Ketamine. Expert peer review on critical review report (1). 35th Expert Committee on Drug Dependence, Hammamet, Tunisia
June 4-8, 2012, WHO
http://www.who.int/medicines/areas/quality_safety/4.2.1ExpertreviewKetaminecriticalreview.pdf
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
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