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In the Hubei region of China, a pneumonia outbreak occurred in December 2019, which was confirmed to be caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). It quickly became known as Coronavirus Disease 2019 or simply COVID-19, a pandemic that continues to devastate countries across the world. Through this COVID-19 pandemic, pharmacists across the globe have continued to offer direct patient care and provided frontline service to society. However, while the frontline staff is heralded, they are relegated to the background and overlooked most of the time. The most reachable healthcare providers are pharmacists because they can provide direct medical services despite tight regulations and restrictions related to the pandemic. During this pandemic, the involvement of pharmacists to handle COVID-19 and its complications proved to be crucial in alleviating the burden on the already strained healthcare system. They have provided very important services such as distributing medications to patients, encouraging adherence to medications for better control of chronic diseases, consulting on minor illnesses, clarifying myths regarding COVID-19, and contributing to COVID-19 screening. The treatment or management of COVID-19 was based on initial findings but is now being updated several times based on viral mutation, different studies across the globe, etc. This review focuses on recent clinical updates and tools that would help pharmacists with a more systematic approach to properly handling COVID-19 and its complications.

Ketamine has been extensively used in the medical field for more than 50 years, but its exact mechanism of action remains unknown. It’s used to induce dissociative anesthesia (a state of profound analgesia, amnesia with light sleep, immobility, and a sense of disassociation from one’s own body and surroundings). Clinical studies on ketamine as a dissociative anesthetic, a model for psychosis, and as a rapidly acting antidepressant have sparked great interest in understanding its effects at the molecular and cellular level. It exerts uncompetitive inhibitory effects on NMDARs (N-Methyl-D-asperate) and may preferentially affect the function of NMDARs in interneurons. The hypnotic effects of this drug are attributed to its blocking action on NMDA and HCN1 receptors; however, both positive and negative modulation of choline, amine, and opioid systems appears to occur. It is likely that ketamine\´s effect on chronic pain and depression far outlasts its actual levels. This could be due to the hyperglutamatergic state induced by ketamine causing a secondary increase in structural synaptic connectivity. The authors of this review have attempted to highlight the action of ketamine not only on NMDA receptors but also on a variety of biochemical processes and functions found in intercellular environments, which may explain its diverse role in many diseases.

SARS-CoV-2 has affected socio-economic activity in every country around the world since its outbreak began in 2019. 3.5 million people have died worldwide as of now, including 3.2 lakh in India. The cytokine storm significantly contributes to COVID mortality. To put it simply, the virus causes an uncontrolled release of cytokines, which results in severe inflammation, multi-organ failure, and death. Vitamin D was discovered to be a significant risk factor for cytokine storm in COVID patients. Numerous studies have demonstrated that those with deficient serum vitamin D levels have a significant mortality rate. The current understanding of the role of vitamin D in immune modulation in the innate and adaptive immune systems and how this may relate to COVID-19 is discussed in this article. Additionally, we evaluated the most recent clinical information about vitamin D deficiency, cytokine storm, and COVID-19 mortality.