Review Article
Volume 4 Issue 5 - 2020
KetaDex 12.5/25 Nasal Spray: A New Sedative-Analgesic Formulation
Darren Emerick1* and Antony Condina2
1Anaesthesiologist, Buderim Private Hospital, Buderim, Queensland, Australia
2Pharmacist, GD Pharma, Norwood, Australia
*Corresponding Author: Darren Emerick, Anaesthesiologist, Buderim Private Hospital, Buderim, Queensland, Australia.
Received: February 12, 2020; Published: April 29, 2020


Intranasal administration offers an alternative route for systemically acting drugs, especially low molecular weight, lipophilic and potent drugs with high first-pass metabolism. It’s well recognized that nasal bioavailability is optimum with atomized volumes less than 100 microlitres (0.1 ml), available ampoule content therefore has limited nasal residence time, absorption and bioavailability due to excess volume that drains into the throat and is swallowed. Ketadex nasal spray offers additive effects of sedation, analgesia, bronchodilation with nasal decongestion and dilation of cutaneous veins for cannulation. Opposing side effects produce dry mouth, reduced secretions and cardiovascular stability. A wide margin of safety is predicted because both ketamine and dexmedetomidine are devoid of respiratory depressant effects. We present an easy to administer nasal spray, concentrated (3.75x) ketamine and dexmedetomidine solution to produce reliable sedation and analgesia with minimal adverse effects due to favourable pharmacokinetic and pharmacodynamic interactions.

Keywords: Ketadex Nasal Spray; Ketamine; Dexmedetomidine


  1. Mason KP and Seth N. “Future of paediatric sedation: towards a unified goal of improving practice”. British Journal of Anaesthesia 122.5 (2019): 652-661.
  2. Friedberg BL. “Propofol Ketamine with Bispectral Index (BIS) Monitoring”. In: Friedberg, BL, ed. Anesthesia in cosmetic surgery. Cambridge, Cambridge University Press (2007): 1-13.
  3. Gertler R., et al. “Dexmedetomidine: a novel sedative-analgesic agent”. Baylor University Medical Center Proceedings 14.1 (2001): 13-21.
  4. Weerink MA., et al. “Clinical pharmacokinetics and pharmacodynamics of dexmedetomidine”. Clinical Pharmacokinetics 56.8 (2017): 893-913.
  5. Mahmoud M and Mason KP. “Dexmedetomidine: review, update, and future considerations of paediatric perioperative and periprocedural applications and limitations”. British Journal of Anaesthesia 115.2 (2015): 171-182.
  6. Mellor J. “Induction of anaesthesia in paediatric patients”. Update in Anaesthesia 18 (2004): 27-30.
  7. O’Sullivan M and Wong GK. “Preinduction techniques to relieve anxiety in children undergoing general anaesthesia”. Continuing Education in Anaesthesia, Critical Care and Pain 13.6 (2013): 196-199.
  8. Lerwick J. “Minimizing pediatric healthcare-induced anxiety and trauma”. World Journal of Clinical Pediatrics 5.2 (2016): 143-150.
  9. Djupesland PG. “Nasal drug delivery devices: characteristics and performance in a clinical perspective - a review”. Drug Delivery and Translational Research 3.1 (2013): 42-62.
  10. Pathak V. “Nasal delivery, a promising route of drug delivery to the brain: scientific considerations”. Drug Development and Delivery 18.2 (2018): 63-68.
  11. Bitter C., et al. “Nasal drug delivery in humans”. Current Problems in Dermatology 40 (2011): 20-35.
  12. Mion G and Villevieille T. “Ketamine pharmacology: an update (pharmacodynamics and molecular aspects, recent findings)”. CNS Neuroscience and Therapeutics 19.6 (2013): 370-380.
  13. Li L and Vlisides PE. “Ketamine: 50 years of modulating the mind”. Frontiers in Human Neuroscience 10 (2016): 612.
  14. Lee M., et al. “A comprehensive review of opioid-induced hyperalgesia”. Pain Physician Journal 14.2 (2011): 145-161.
  15. Yang F., et al. “Analysis of 17 948 pediatric patients undergoing procedural sedation with a combination of intranasal dexmedetomidine and ketamine”. Pediatric Anesthesia 29.1 (2019): 85-91.
  16. Prescilla RP. “The pharmacology and clinical application of sedatives, analgesics, and adjuncts”. In: Mason, KP, ed. Pediatric sedation outside of the operating room a multispecialty international collaboration 2nd edition. New York, Springer (2014): 570-731.
  17. Australian Government Department of Health and Ageing. Therapeutic Goods Administration. Manufacturing Medicines (2020). 
  18. Brown EN., et al. “Multimodal general anesthesia: theory and practice”. Anesthesia and Analgesia 127.5 (2018): 1246-1258.
  19. Kumar K., et al. “A review of opioid-sparing modalities in perioperative pain management: methods to decrease opioid use postoperatively”. Anesthesia and Analgesia 125.5 (2017): 1749-1760.
  20. Soffin EM., et al. “The prescription opioid crisis: role of the anaesthesiologist in reducing opioid use and misuse”. British Journal of Anaesthesia 122.6 (2019): e198-e208.
  21. Australian Government Department of Health and Ageing. Therapeutic Goods Administration. Therapeutic goods regulations Exempt goods Schedule 5 and 5A December 1997 (2020). 
Citation: Darren Emerick and Antony Condina. “KetaDex 12.5/25 Nasal Spray: A New Sedative-Analgesic Formulation”. EC Emergency Medicine and Critical Care 4.5 (2020): 01-08.

PubMed Indexed Article

EC Pharmacology and Toxicology
LC-UV-MS and MS/MS Characterize Glutathione Reactivity with Different Isomers (2,2' and 2,4' vs. 4,4') of Methylene Diphenyl-Diisocyanate.

PMID: 31143884 [PubMed]

PMCID: PMC6536005

EC Pharmacology and Toxicology
Alzheimer's Pathogenesis, Metal-Mediated Redox Stress, and Potential Nanotheranostics.

PMID: 31565701 [PubMed]

PMCID: PMC6764777

EC Neurology
Differences in Rate of Cognitive Decline and Caregiver Burden between Alzheimer's Disease and Vascular Dementia: a Retrospective Study.

PMID: 27747317 [PubMed]

PMCID: PMC5065347

EC Pharmacology and Toxicology
Will Blockchain Technology Transform Healthcare and Biomedical Sciences?

PMID: 31460519 [PubMed]

PMCID: PMC6711478

EC Pharmacology and Toxicology
Is it a Prime Time for AI-powered Virtual Drug Screening?

PMID: 30215059 [PubMed]

PMCID: PMC6133253

EC Psychology and Psychiatry
Analysis of Evidence for the Combination of Pro-dopamine Regulator (KB220PAM) and Naltrexone to Prevent Opioid Use Disorder Relapse.

PMID: 30417173 [PubMed]

PMCID: PMC6226033

EC Anaesthesia
Arrest Under Anesthesia - What was the Culprit? A Case Report.

PMID: 30264037 [PubMed]

PMCID: PMC6155992

EC Orthopaedics
Distraction Implantation. A New Technique in Total Joint Arthroplasty and Direct Skeletal Attachment.

PMID: 30198026 [PubMed]

PMCID: PMC6124505

EC Pulmonology and Respiratory Medicine
Prevalence and factors associated with self-reported chronic obstructive pulmonary disease among adults aged 40-79: the National Health and Nutrition Examination Survey (NHANES) 2007-2012.

PMID: 30294723 [PubMed]

PMCID: PMC6169793

EC Dental Science
Important Dental Fiber-Reinforced Composite Molding Compound Breakthroughs

PMID: 29285526 [PubMed]

PMCID: PMC5743211

EC Microbiology
Prevalence of Intestinal Parasites Among HIV Infected and HIV Uninfected Patients Treated at the 1o De Maio Health Centre in Maputo, Mozambique

PMID: 29911204 [PubMed]

PMCID: PMC5999047

EC Microbiology
Macrophages and the Viral Dissemination Super Highway

PMID: 26949751 [PubMed]

PMCID: PMC4774560

EC Microbiology
The Microbiome, Antibiotics, and Health of the Pediatric Population.

PMID: 27390782 [PubMed]

PMCID: PMC4933318

EC Microbiology
Reactive Oxygen Species in HIV Infection

PMID: 28580453 [PubMed]

PMCID: PMC5450819

EC Microbiology
A Review of the CD4 T Cell Contribution to Lung Infection, Inflammation and Repair with a Focus on Wheeze and Asthma in the Pediatric Population

PMID: 26280024 [PubMed]

PMCID: PMC4533840

EC Neurology
Identifying Key Symptoms Differentiating Myalgic Encephalomyelitis and Chronic Fatigue Syndrome from Multiple Sclerosis

PMID: 28066845 [PubMed]

PMCID: PMC5214344

EC Pharmacology and Toxicology
Paradigm Shift is the Normal State of Pharmacology

PMID: 28936490 [PubMed]

PMCID: PMC5604476

EC Neurology
Examining those Meeting IOM Criteria Versus IOM Plus Fibromyalgia

PMID: 28713879 [PubMed]

PMCID: PMC5510658

EC Neurology
Unilateral Frontosphenoid Craniosynostosis: Case Report and a Review of the Literature

PMID: 28133641 [PubMed]

PMCID: PMC5267489

EC Ophthalmology
OCT-Angiography for Non-Invasive Monitoring of Neuronal and Vascular Structure in Mouse Retina: Implication for Characterization of Retinal Neurovascular Coupling

PMID: 29333536 [PubMed]

PMCID: PMC5766278

EC Neurology
Longer Duration of Downslope Treadmill Walking Induces Depression of H-Reflexes Measured during Standing and Walking.

PMID: 31032493 [PubMed]

PMCID: PMC6483108

EC Microbiology
Onchocerciasis in Mozambique: An Unknown Condition for Health Professionals.

PMID: 30957099 [PubMed]

PMCID: PMC6448571

EC Nutrition
Food Insecurity among Households with and without Podoconiosis in East and West Gojjam, Ethiopia.

PMID: 30101228 [PubMed]

PMCID: PMC6086333

EC Ophthalmology
REVIEW. +2 to +3 D. Reading Glasses to Prevent Myopia.

PMID: 31080964 [PubMed]

PMCID: PMC6508883

EC Gynaecology
Biomechanical Mapping of the Female Pelvic Floor: Uterine Prolapse Versus Normal Conditions.

PMID: 31093608 [PubMed]

PMCID: PMC6513001

EC Dental Science
Fiber-Reinforced Composites: A Breakthrough in Practical Clinical Applications with Advanced Wear Resistance for Dental Materials.

PMID: 31552397 [PubMed]

PMCID: PMC6758937

EC Microbiology
Neurocysticercosis in Child Bearing Women: An Overlooked Condition in Mozambique and a Potentially Missed Diagnosis in Women Presenting with Eclampsia.

PMID: 31681909 [PubMed]

PMCID: PMC6824723

EC Microbiology
Molecular Detection of Leptospira spp. in Rodents Trapped in the Mozambique Island City, Nampula Province, Mozambique.

PMID: 31681910 [PubMed]

PMCID: PMC6824726

EC Neurology
Endoplasmic Reticulum-Mitochondrial Cross-Talk in Neurodegenerative and Eye Diseases.

PMID: 31528859 [PubMed]

PMCID: PMC6746603

EC Psychology and Psychiatry
Can Chronic Consumption of Caffeine by Increasing D2/D3 Receptors Offer Benefit to Carriers of the DRD2 A1 Allele in Cocaine Abuse?

PMID: 31276119 [PubMed]

PMCID: PMC6604646

EC Anaesthesia
Real Time Locating Systems and sustainability of Perioperative Efficiency of Anesthesiologists.

PMID: 31406965 [PubMed]

PMCID: PMC6690616

EC Pharmacology and Toxicology
A Pilot STEM Curriculum Designed to Teach High School Students Concepts in Biochemical Engineering and Pharmacology.

PMID: 31517314 [PubMed]

PMCID: PMC6741290

EC Pharmacology and Toxicology
Toxic Mechanisms Underlying Motor Activity Changes Induced by a Mixture of Lead, Arsenic and Manganese.

PMID: 31633124 [PubMed]

PMCID: PMC6800226

EC Neurology
Research Volunteers' Attitudes Toward Chronic Fatigue Syndrome and Myalgic Encephalomyelitis.

PMID: 29662969 [PubMed]

PMCID: PMC5898812

EC Pharmacology and Toxicology
Hyperbaric Oxygen Therapy for Alzheimer's Disease.

PMID: 30215058 [PubMed]

PMCID: PMC6133268

News and Events

October Issue Release

We always feel pleasure to share our updates with you all. Here, notifying you that we have successfully released the October issue of respective journals and the latest articles can be viewed on the current issue pages.

Submission Deadline for Upcoming Issue

Ecronicon delightfully welcomes all the authors around the globe for effective collaboration with an article submission for the upcoming issue of respective journals. Submissions are accepted on/before November 08, 2021.

Certificate of Publication

Ecronicon honors with a "Publication Certificate" to the corresponding author by including the names of co-authors as a token of appreciation for publishing the work with our respective journals.

Best Article of the Issue

Editors of respective journals will always be very much interested in electing one Best Article after each issue release. The authors of the selected article will be honored with a "Best Article of the Issue" certificate.

Certifying for Review

Ecronicon certifies the Editors for their first review done towards the assigned article of the respective journals.

Latest Articles

The latest articles will be updated immediately on the articles in press page of the respective journals.

Immediate Assistance

The prime motto of this team is to clarify all the queries without any delay or hesitation to avoid the inconvenience. For immediate assistance on your queries please don't hesitate to drop an email to