American journal of therapeutics
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One of the most fascinating drugs in the anesthesiologist's armament is ketamine, an N-methyl-D-aspartate receptor antagonist with a myriad of uses. The drug is a dissociative anesthetic and has been used more often as an analgesic in numerous hospital units, outpatient pain clinics, and in the prehospital realm. It has been used to treat postoperative pain, chronic pain, complex regional pain syndrome, phantom limb pain, and other neuropathic conditions requiring analgesia. ⋯ Such effects make it necessary for the clinician to use the drug only in situations where it will provide the greatest benefit with the fewest adverse effects. To the best of our knowledge, none of the reviews regarding ketamine have taken a comprehensive look at the drug's uses in all territories of medicine. This review will serve to touch on its chemical data, pharmacokinetics and pharmacodynamics, medical uses, and adverse effects while focusing specifically on the drugs usage in anesthesia and analgesia.
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Vitamin D deficiency is known to be common in the general population and has been linked to all-cause mortality. The classically recognized role of vitamin D is its involvement in calcium and phosphorous homeostasis and bone health. ⋯ Many of these studies have indicated that there is an association between vitamin D deficiency and clinical outcomes such as mortality, sepsis, duration of mechanical ventilation, and length of stay. This review article provides an overview of vitamin D physiology in adults, a summary of observational studies on vitamin D deficiency in critical illness, and an examination of the few clinical trials on vitamin D supplementation in intensive care patients.