Ketamine

Table of contents

  • Brand Names
  • Chemistry
  • Pharmacologic Category
  • Mechanism of Action
  • Therapeutic Use
  • Unlabeled Use
  • Pregnancy and Lactation Implications
  • Contraindications
  • Warnings and Precautions
  • Adverse Reactions
  • Caution and personalized dose adjustment in patients with the following genotypes
  • Other genes that may be involved
  • Substrate of
  • Inhibits
  • Drug Interactions
  • Dosage
  • Pharmacokinetics and Pharmacodynamics
  • Special Considerations

Brand Names

Europe

Belgium: Ketalar; Bulgaria: Calypsol; Czech Republic: Calypsol, Narkamon; Finland: Ketanest; France: Ketamine; Germany: Ketamin, Ketanest; Greece: Ketamine, Ketanest; Hungary: Calypsol; Ireland: Ketalar; Luxembourg: Ketalar; Poland: Calypsol, Ketanest; Portugal: Ketalar; Romania: Calypsol, Ketamine; Slovakia: Calypsol, Narkamon; Spain: Ketolar; Sweden: Ketalar; UK: Ketalar.

North America

Canada: Ketalar, Ketamine; USA: Ketalar, Ketamine.

Latin America

Argentina: Cost, Inducmina, Ketamina, Ketanest; Brazil: Ketalar, Ketamin; Mexico: Ketalin, Ketamina.

Asia

Japan: Ketalar.

Drug combinations

Chemistry

Ketamine Hydrochloride: C~13~H~16~ClNO HCl. Mw: 274.19. (1) Cyclohexanone, 2-(2-chlorophenyl)-2-(methylamino)-, hydrochloride; (2)(±)-2-(o-Chlorophenyl)-2-(methylamino)cyclohexanone hydrochloride. CAS-1867-66-9; CAS-6740-88-1 (ketamine)(1966).

Pharmacologic Category

General Anesthetics, Miscellaneous. (ATC-Code: N01AX14; N01AX03).

Mechanism of action

Produces cataleptic-like state in which patient is dissociated from surrounding environment by direct action on cortex and limbic system. Releases endogenous catecholamines (epinephrine, norepinephrine) which maintain blood pressure and heart rate. Reduces polysynaptic spinal reflexes.

Therapeutic use

Induction and maintenance of general anesthesia.

Pregnancy and lactiation implications

Crosses placenta and can be detected in fetal tissue. Ketamine produces dose-dependent increases in uterine contractions. Effects may vary by trimester.

Unlabeled use

Analgesia, sedation.

Contraindications

Hypersensitivity to ketamine or any component of the formulation. Conditions in which increase in blood pressure would be hazardous. Contraindicated in psychotic disorders.

Warnings and precautions

May cause CNS depression. May cause dependence (withdrawal symptoms on discontinuation) and tolerance with prolonged use. Postanesthetic emergence reactions occur. Rapid I.V. administration or overdose may cause respiratory depression, apnea, and enhanced pressor response. Use with caution in coronary artery disease, catecholamine depletion, hypertension, and tachycardia. Use with caution in cerebrospinal fluid pressure elevation. Use with caution in the chronic alcoholic or acutely alcohol-intoxicated.

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