Ketamine in seizure management and future pharmacogenomic considerations

Giovanna Soldatelli Borsato, Jason L. Siegel, Mariah Q. Rose, Michelle Ojard, Anteneh Feyissa, Alfredo Quinones-Hinojosa, Daniel A. Jackson, Emily R. Rogers, William D. Freeman

Research output: Contribution to journalReview article

Abstract

Ketamine is a noncompetitive N-methyl-D-aspartate antagonist with emerging evidence for use in medically refractory epilepsy. We describe the novel use of low-dose intravenous (IV) ketamine transitioning to enteral formulation in a patient with drug-resistant localization-related refractory epilepsy. We performed a National Library of Medicine (NLM) literature review using search terms “ketamine”, “low dose”, and “seizure” for similar cases, followed by an illustrative clinical case. Our NLM search engine methodology yielded 24 hits, none of which described use of low-dose ketamine for seizures. Anesthetic doses are used for status epilepticus, but we show that in a patient with postoperative worsening of his chronic seizure burden, low-dose IV ketamine can be used to avoid oversedation and intubation. We demonstrate that IV ketamine can be transitioned to oral regimen to shorten length of stay in the intensive care unit and hospital and has future CYP2B6 pharmacogenomic considerations for further dose individualization.

Original languageEnglish (US)
JournalPharmacogenomics Journal
DOIs
StateAccepted/In press - Jan 1 2019

Fingerprint

Pharmacogenetics
Ketamine
Seizures
National Library of Medicine (U.S.)
Search Engine
Partial Epilepsy
Status Epilepticus
N-Methylaspartate
Intubation
Small Intestine
Intensive Care Units
Anesthetics
Epilepsy
Length of Stay

ASJC Scopus subject areas

  • Molecular Medicine
  • Genetics
  • Pharmacology

Cite this

Borsato, G. S., Siegel, J. L., Rose, M. Q., Ojard, M., Feyissa, A., Quinones-Hinojosa, A., ... Freeman, W. D. (Accepted/In press). Ketamine in seizure management and future pharmacogenomic considerations. Pharmacogenomics Journal. https://doi.org/10.1038/s41397-019-0120-2

Ketamine in seizure management and future pharmacogenomic considerations. / Borsato, Giovanna Soldatelli; Siegel, Jason L.; Rose, Mariah Q.; Ojard, Michelle; Feyissa, Anteneh; Quinones-Hinojosa, Alfredo; Jackson, Daniel A.; Rogers, Emily R.; Freeman, William D.

In: Pharmacogenomics Journal, 01.01.2019.

Research output: Contribution to journalReview article

Borsato, GS, Siegel, JL, Rose, MQ, Ojard, M, Feyissa, A, Quinones-Hinojosa, A, Jackson, DA, Rogers, ER & Freeman, WD 2019, 'Ketamine in seizure management and future pharmacogenomic considerations', Pharmacogenomics Journal. https://doi.org/10.1038/s41397-019-0120-2
Borsato, Giovanna Soldatelli ; Siegel, Jason L. ; Rose, Mariah Q. ; Ojard, Michelle ; Feyissa, Anteneh ; Quinones-Hinojosa, Alfredo ; Jackson, Daniel A. ; Rogers, Emily R. ; Freeman, William D. / Ketamine in seizure management and future pharmacogenomic considerations. In: Pharmacogenomics Journal. 2019.
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