Ketamine
•Download as PPTX, PDF•
63 likes•14,435 views
A General Anaesthetic is a drug that produces a reversible state of unconscious with absence of pain sensation over the entire body; such agents have been described as drugs that remove the most precious human attributes ---- Conscious. Ketamine Brand name: KETALAR Phencyclidine derivative Shorting acting Mainly used in children and elderly adults for short procedures such as burns dressing. ABUSIVE DRUG Is a dissociative anaesthetic as it produces a cataleptic state in which the patient appears to be awake but is detached from the environment and is unresponsive to pain. Please also refer to other reference books for clarity.
Recommended
More Related Content
What's hot
What's hot (20)
Similar to Ketamine
Similar to Ketamine (20)
Recently uploaded
Recently uploaded (20)
Ketamine
- 2. Overview • A General Anaesthetic is a drug that produces a reversible state of unconscious with absence of pain sensation over the entire body; such agents have been described as drugs that remove the most precious human attributes ---- Conscious. • For a drug to be useful as a general anaesthetic, its actions must be of rapid onset.
- 3. Intravenous Anaesthetics • Used for induction or maintenance of general anaesthesia, sedation and to induce amnesia. Major Groups Barbiturates Thiopental Non- Barbiturates KETAMINE Propofol
- 4. Ketamine • Brand name: KETALAR • Phencyclidine derivative • Shorting acting • Mainly used in children and elderly adults for short procedures such as burns dressing. • ABUSIVE DRUG
- 6. • Is a dissociative anaesthetic as it produces a cataleptic state in which the patient appears to be awake but is detached from the environment and is unresponsive to pain. • Ketamine is frequently described as a "unique drug" because it has hypnotic, analgesic and amnesic effects - no other drug used in clinical practice combines these three important features.
- 7. Pharmacokinetics Given IV or IM therefore: • Rapid onset of action: 30 to 60 sec. Distribution Initially is distributed to highly perfused tissues such as brain. Extreme lipid solubility ensures its rapid transfer across the BBB. • Volume of distribution: 2.5-3.5 lit/kg
- 8. Metabolism Hepatic microsomal enzymes cytochrome P450 by N-demethylation to form nor ketamine which is hydroxylated and conjugated to water soluble glucuronide derivatives and excreted in urine.
- 9. Elimination • Elimination half time: 2-3 hours • High hepatic clearance rate: 1 L/min
- 10. Mode of Action (PD) • Antagonises N-methyl- D- aspartate (NMDA) receptors; also interacts with muscarinic receptor, descending monoaminergic pain pathways, voltage- sensitive calcium channels and opioid receptors in brain and spinal cord.
- 11. Clinical Uses • Sedation • Amnesia • Immobility • Analgesic • Loss of consciousness • Pain relief in post operative care (instead of morphine)
- 12. Effect on Body System Cardiovascular • Stimulates sympathetic flow, causing stimulation of heart with increased BP and CO. • The heart rate is increased by about 20% - the overall effect is therefore to increase the workload of the heart. (Contraindicated in hypertensive or stroke patient)
- 13. Respiratory • Causes Bronchodilation (Potent Bronchodilator) (Beneficial in patients with hypovolemic or cardiogenic shock and in asthmatics)
- 14. CNS Lipophilic drug therefore enters CNS quickly. This causes hallucinations, sedations. Good analgesic effect. • Potent cerebral vasodilator & capable of increasing cerebral blood flow by 60% in normal individual
- 15. Dosage • Same doses are used for adults and children. Induction IV, 1-4.5mg/kg IM, 6.5- 12mg/kg Drug Interaction Atracurium + Ketamine (will reduce dose of atracurium) used for skeletal muscle relaxation in anaesthesia and intensive care.
- 16. Adverse Effects • BP & Pulse rate • muscle tone (sometimes tonic-clonic & resembling seizures) • Lacrimation • Salivation • Intracranial pressure & IOP • Nausea & Vomiting
- 18. Reference • Australian medicines handbook 2016 (2016) 2016th edn. Australia: Australian Medicines Handbook Pty. • Knights, K. and Miners, J.O. (2015) Pharmacology for health professionals Workbook. 4th edn. Australia: Harcourt Publishers Group (Australia) Pty. • Whalen, K. and Pharmacology (2014) Lippincott illustrated reviews: Pharmacology. Edited by Richard A. Harvery. 6th edn. United States: Lippincott Williams and Wilkins. • EPSVideoOnline (2014) Club drugs: Ketamine. Available at: https://www.youtube.com/watch?v=z92LTc1ZX40 (Accessed: 5 May 2016).