Javelin Pharmaceuticals Inc (JAV)

[kcalt]

YMI's fentanyl, belonging to the opioid class, would show respiratory depression/oxygen desaturation due to stim of mu2 receptors in the medullary respiratory centers of the brain. It is also of interest that fentanyl is extremely potent- 80x more potent than morphine. Also, fentanyl PATCHES are contraind. in pts post-surgery due to potential for severe resp. depression. I can only imagine what the risk would be for spray version that is patient-dosed...

Respiratory depression is usually seen with the use of a single, intravenous dose in an opioid-naive patient. In patients taking opioids regularly for pain relief, tolerance to respiratory depression occurs rapidly, so that it is not a clinical problem.

As JAV's products are non-opioid, i would imagine that respiratory depression will be of less risk. However, ketamine does stim opioid mu receptors- but only at high doses that are used to induce anesthesia. It is of interest that ketamine often has effects opposite opioids, ie cardiac output and HR actually increase with anesthetic does of K. As long as none of the patients are allowed to enter stage 2 anesthesia we should be ok :)