3 S-ketamine oral thin film pharmacodynamics Conclusions In this pharmacokinetic-pharmacodynamic modeling study, we tested the antinociceptive and drug high effects of an S-ketamine OTF. The OTF was safe and side effects were related to ketamine itself and not to the thin film. Despite low bioavailability (on average 26%), the S-ketamine OTF produced potent antinociceptive responses in all three assays lasting 2-6 h, effects that were related toS-ketamine and not to its two metabolites, S-norketamine andShydroxynorketamine. The clinical indication of the OTF is primarily treatment of acute pain, for example in the emergency room, in the ambulance following acute trauma or for wound dressing. Additionally, we see a place for the Sketamine OTF in the treatment of severe (cancer and non-cancer) breakthrough pain. However, further clinical studies are needed to address this issue. 59
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