Medication

Ketamine

Structure

1 ml of a 5% solution contains 50 mg of the active ingredient ketamine hydrochloride.

Release form

Ketamine is available in ampoules of 2 and 10 ml. Each pack of cardboard contains 10 ampoules.

Pharmachologic effect

What is Ketamine? This is a tool that, with intramuscular or intravenous infusion, is capable of exerting anesthetizing (anesthetic) and analgesic effects. Pharmacological group - "Anesthetic drugs". The active substance has a short effect, and in narcotic doses allows you to maintain adequate independent breathing. The drug has a dissociative general anesthesia, which is explained by a depressing effect on the subcortical formations of the thalamus and the associative zone.

Ketamine mechanism of action based on the selective suppression of neuronal transmission in the structure of the cerebral cortex, as in thalamus, and in associative zones. At the same time, there is stimulation limbic system and hippocampus. As a result, functional dissociation of nonspecific connections in the structure of the thalamus and midbrain develops, incoming nociceptive afferent stimuli to the higher brain centers from the spinal cord are blocked, impulse transmission to the medulla oblongata (reticular formation) is inhibited. It is believed that the analgesic and hypnotic effects of Ketamine are associated with the influence of the active substance on various types of receptors. The effects of the drug are not associated with the blocking of sodium channels in the nervous system and the effect on GABA receptors. Wikipedia contains information on the history of the synthesis of Ketamine.

Pharmacodynamics and pharmacokinetics

Ketamine is a lipophilic compound that can quickly be distributed first in well-circulated organs, and then in tissues with reduced perfusion. Metabolized in the hepatic system. It is excreted through the kidneys in the form of conjugated metabolite substances.

Indications for use

Ketamine what is it? The medication is used both for mononarcosis (1 component), and for combined anesthesia mainly in people with low blood pressure, or if it is necessary to maintain independent breathing in the patient. Most often, ketamine is used during evacuation of massive blood loss and traumatic shock, with short-term cardiac surgery, in emergency surgery. Ketamine is prescribed for:

  • cardiac catheterization;
  • endoscopic manipulations;
  • dressings in otorhinolaryngology, ophthalmology and dentistry.

The medication can be used for cesarean section in obstetric practice.

Contraindications

  • epilepsy;
  • cerebrovascular accident;
  • eclampsiain severe form of circulatory decompensation;
  • severe hypertension.

If necessary muscle relaxants during laryngeal surgery, ketamine is prescribed with caution. Mixing with barbiturate solutions is unacceptable due to the risk of precipitation.

Side effects

The medication has a general effect on the human body. With the introduction of the solution, a rise in blood pressure of 20-30%, an increase in heart rate, an increase in the minute volume of blood, and a decrease in peripheral vascular resistance are recorded. Application of Sibazon (Diazepam) helps to reduce the stimulating effect of Ketamine on cardiac activity. In most cases, the active component does not inhibit the reflexes of the upper respiratory tract, does not cause bronchospasm, laryngospasm, vomiting and nausea. Respiratory depression recorded with rapid intravenous infusion of a solution. Atropine and Metacin can reduce salivation. With the introduction of the medication, they can be registered hallucinations, hypertonicity, involuntary movements (stopped with the introduction Droperidol and tranquilizers). Perhaps redness of the skin along the vein at the injection site; upon awakening from anesthesia - prolonged disorientation and psychomotor agitation.

Instructions for use of Ketamine (Method and dosage)

The solution is administered intravenously (fractionally / jet) or intramuscularly. Intravenously, adults are administered 2-3 mg, intramuscularly - 4-8 mg per 1 kg of weight. Repeated administration of Ketamine allows prolonging anesthesia (speed 2 mg / kg / hour). This method of administration is possible in the presence of infusomats or is achieved by dropwise administration of a ketamine solution of 1% in a solution of sodium chloride or isotonic solution (30-60 drops per minute).

In pediatric practice, the solution is used for combined anesthesia. The calculation is made according to the scheme: 4-5 mg / kg in the form of a solution of 5%. Mandatory sedation is required.

The drug can be used in conjunction with analgesics (Promedol, Fentanyl, depidolor, etc.) and antipsychotics (for example, droperidol), however, this requires a dose reduction.

Overdose

Is registered respiratory depressionthat requires timely mechanical ventilation.

Interaction

Ketamine is incompatible with barbiturates at the chemical level (precipitate forms). The medication is able to potentiate the effect of all the drugs used to inhalation anesthesia. The drug enhances the action of tubocurarine, but does not affect the effectiveness of succinylcholine and pancuronium.

Terms of sale

It is sold only for hospitals and medical institutions, is not intended for free sale.

Storage conditions

The manufacturer recommends observing the standard temperature regime of 15-25 degrees. Limit the admission of children to the solution.

Shelf life

5 years.

Special instructions

With pathology of the renal system, it is used with caution. With surgical interventions on the pharynx and larynx, the introduction of muscle relaxants is mandatory. During the day after the introduction of Ketamine, you can not drive vehicles due to the inhibition of the reaction and decreased attention.

Analogs

Matches for ATX Level 4 code:CalypsolDiprivanNitrous oxideSodium OxybutyratePropofol
  • Calypsol;
  • Ketanest;
  • Ketalar.

During pregnancy and lactation

The active component passes through the placental barrier. At the moment, the safety of using Ketamine in pregnant women not installed. Not recommended for use by pregnant women and in lactation.

Ketamine Reviews

From anesthetists who constantly use Ketamine in their practice, you can only hear positive reviews about the medication.

Ketamine price where to buy

Only medical institutions are engaged in the purchase. Buying Ketamine on your own is impossible. The price for hospitals depends on the region, the volume of purchase (on average, the cost of one package is 1200 rubles).

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