{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T15:26:44Z","timestamp":1787153204371,"version":"build-2736575974"},"reference-count":14,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T00:00:00Z","timestamp":1762300800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Palliative Medicine"],"published-print":{"date-parts":[[2026,9,1]]},"abstract":"\n Background:<\/jats:title>\n Ketamine is an N-methyl-D-aspartate receptor antagonist traditionally used for dissociative sedation that has also been used for the treatment of pain. Ketamine can have a higher bioavailability when administered intranasally.<\/jats:p>\n <\/jats:sec>\n \n Objective:<\/jats:title>\n To present a case in which intranasal (IN) ketamine was used for unpredictable, episodic, cancer-related neuropathic pain.<\/jats:p>\n <\/jats:sec>\n \n Case Presentation:<\/jats:title>\n We present a 49-year-old patient with metastatic adenocarcinoma of the lung who presented to our outpatient palliative care clinic with uncontrolled severe episodic neuropathic pain of the lower extremity.<\/jats:p>\n <\/jats:sec>\n \n Case Management:<\/jats:title>\n We prescribed compounded racemic ketamine 20\u201330 mg intranasally as needed at the onset of severe episodes of breakthrough pain, in addition to scheduled use of oral methadone and a buprenorphine patch for long-acting pain management.<\/jats:p>\n <\/jats:sec>\n \n Case Outcome:<\/jats:title>\n The patient reported a decrease in frequency, intensity, and duration of episodic breakthrough pain with use of IN ketamine without any reported negative adverse effects.<\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Low-dose compounded racemic IN ketamine may be a useful and safe adjunct in alleviating severe breakthrough pain in cancer patients in the outpatient setting.<\/jats:p>\n <\/jats:sec>","DOI":"10.1177\/10966218251394602","type":"journal-article","created":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T11:01:52Z","timestamp":1762340512000},"page":"1338-1340","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Intranasal Ketamine for Episodic Neuropathic Pain in a Cancer Patient: A Case Report"],"prefix":"10.1177","volume":"29","author":[{"given":"Kyle","family":"Brown","sequence":"first","affiliation":[{"name":"Department of Palliative Medicine, OSF Saint Francis Medical Center, University of Illinois College of Medicine at Peoria, Peoria, Illinois, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tayyaba","family":"Irshad","sequence":"additional","affiliation":[{"name":"Department of Palliative Medicine, OSF Saint Francis Medical Center, University of Illinois College of Medicine at Peoria, Peoria, Illinois, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,11,5]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1080\/20961790.2017.1285219"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2010.08.017"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/phar.2090"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsych.2014.03.026"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.3390\/cancers15020400"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2024.03.137"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2024.0040"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/AJP.0000000000000918"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jemermed.2018.12.007"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.3390\/pharmaceutics16040519"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.4103\/jrms.JRMS_505_20"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1002\/phar.2669"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejpain.2009.08.002"},{"key":"e_1_3_2_15_2","unstructured":"U.S. Food and Drug Administration. (2023). FDA alerts health care professionals of potential risks associated with compounded ketamine nasal spray. Available from: https:\/\/www.fda.gov\/drugs\/human-drug-compounding\/fda-alerts-health-care-professionals-potential-risks-associated-compounded-ketamine-nasal-spray"}],"container-title":["Journal of Palliative Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10966218251394602","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10966218251394602","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10966218251394602","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T14:46:32Z","timestamp":1787150792000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10966218251394602"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,5]]},"references-count":14,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9,1]]}},"alternative-id":["10.1177\/10966218251394602"],"URL":"https:\/\/doi.org\/10.1177\/10966218251394602","relation":{},"ISSN":["1096-6218","1557-7740"],"issn-type":[{"value":"1096-6218","type":"print"},{"value":"1557-7740","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,5]]}}}