Ketamine

dr.joandr.joan عضو ماسي
تم تعديل 2009/06/30 في أدوية الطوارئ Emergency drugs
Ketamine :
Trade names: Ketamin, Ketalar
Class: short-acting anesthetic
Pregnancy: (Category B)
Action: inhibit the action of, the N-methyl d-aspartate receptor (NMDAR).
Uses:
  • Ketamine is frequently described as 'unique drug' because it has hypnotic( sleep producing), analgesic( pain relieving), and amnesic ( short term memory loss) effects , no other drug used in clinical practice combines the three important features.
  • Ketamine used as a anesthetic, however due to the severe hallucinations caused by ketamine, there are better anesthetics for victims with unknown medical history.
  • Ketamine can be used in podiatry and other minor surgery, and occasionally for the treatment of migraine.
  • There is ongoing research into the drug's usefulness in pain therapy, depression suppression, and for the treatment of alcoholism and heroin addiction.
Dose:
§ by intramuscular injection, short procedures, initially 6.5–13 mg/kg (10 mg/kg usually produces 12–25 minutes of surgical anesthesia).
§ By intravenous injection over at least 60 seconds, short procedures, initially 1–4.5 mg/kg (2 mg/kg usually produces 5–10 minutes of surgical anesthesia).
§ By intravenous infusion of a solution containing 1 mg/mL, longer procedures, induction, total dose of 0.5–2 mg/kg; maintenance (using micro drip infusion), 10–45 micrograms/kg/minute, rate adjusted according to response
Contraindications:
  • allergic to any ingredient in Ketamine
  • have a condition in which a large increase in blood pressure would be harmful
Side effects:
increased heart rate
slurred speech
paralyzed feeling
nausea
unable to move
hallucination
numbness
impaired attention, memory and learning ability
delirium, amnesia, impaired motor function, high blood pressure, depression and potentially fatal respiratory problems at higher doses
Symptoms of Ketamine overdose
Ketamine can induce unconsciousness and failure of the cardiovascular system, leading to death. There are at least seven Ketamine related deaths known nationally.
Nursing considerations:

if Ketamine is administered rapidly by IV injection it often causes respiratory depression so it given only under severe precautions.
In the majority of people it increase the heart workload resulting in increase of BP and Pulse so close monitoring of vital signs is very important.