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Mahmoud Mosli
Daniel Ovakim
Rommel Tirona
George Dresser
Bandar Al-Judaibi


Shock, hypotension, bacterial infections, midazolam, interactions


We describe the pharmacological evaluation of a 60 year old female admitted to the intensive care unit with severe necrotizing fasciitis not responding to excessive dosages of intravenous sedatives and analgesics. This evaluation revealed the first to be reported midazolam-ketamine drug interaction in the medical literature and explains how we were able to answer a relevant clinical question using pharmacokinetics and pharmacodynamics analysis of serum drug levels.

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