Ketamine (Ketamine). Medicinal guide geotar Ketamine - release form
solution for injections. 50 mg/ml: 2 ml amp. 10 pieces. or 10 ml vial. 5 pieces.Reg. No: 8825/08/14 dated 01/21/2014 - Expired
Injection as a clear, colorless or slightly colored liquid.
Excipients: benzethonium chloride, sodium chloride, water for injections.
2 ml - ampoules (10) - packs.
10 ml - bottles (5) - packs.
Description of active ingredients drug KETAMINE. The provided scientific information is general and cannot be used to make a decision on the possibility of using a particular medicinal product. Date of update: 01/14/2006
Means for non-inhalation anesthesia. With a single intravenous injection of ketamine, the narcotic effect occurs 30-60 seconds after administration and lasts 5-10 minutes (up to 15 minutes). With the / m administration of ketamine at a dose of 4-8 mg / kg, the effect occurs after 2-4 minutes (up to 6-8 minutes) and lasts an average of 12-25 minutes (up to 30-40 minutes). Ketamine causes a pronounced analgesic effect (up to 2 hours), but insufficient muscle relaxation. With the introduction of ketamine, pharyngeal, laryngeal and cough reflexes, independent adequate pulmonary ventilation are preserved. Metabolized in the liver.
Ketamine is a lipophilic compound and, therefore, is rapidly distributed to organs well supplied with blood, incl. in the brain, and then redistributed to tissues with reduced perfusion. Metabolized in the liver. T1 / 2 is 2-3 hours. It is excreted by the kidneys mainly in the form of conjugated metabolites.
For induction and basic anesthesia, for short-term surgical interventions, requiring and not requiring muscle relaxation, with painful instrumental and diagnostic manipulations, during transportation of patients, treatment of the burn surface.
Depending on the indications, the age of the patient, the clinical situation, drugs used for premedication, a single dose for intravenous administration is 0.5-4.5 mg/kg, for intramuscular administration - 4-13 mg/kg.
From the side of cardio-vascular system: increased blood pressure, tachycardia.
From the side digestive system: hypersalivation.
From the side of the central nervous system: psychomotor agitation and hallucinations in the period of recovery from anesthesia.
From the side respiratory system: shortness of breath, respiratory depression.
Local reactions: extremely rarely, pain and hyperemia along the vein is possible at the injection site.
Violations cerebral circulation, arterial hypertension, angina pectoris and heart failure in the decompensation phase, preeclampsia and eclampsia, epilepsy in childhood.
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 drug that, when administered intramuscularly or intravenously, is capable of exerting an anesthetic (anesthetic) and analgesic effect. Pharmacological group – "Drugs" . The active substance has a short-term effect, and in narcotic doses it allows you to maintain adequate spontaneous breathing. The drug has a dissociative general anesthesia, which is explained by the inhibitory effect on the subcortical formations of the thalamus and the associative zone.
Mechanism of action of Ketamine is based on the selective suppression of neuronal transmission in the structure of the cerebral cortex, as in thalamus , as well as in association areas. At the same time, there is stimulation limbic system and hippocampus . As a result, functional dissociation of non-specific connections develops in the structure of the thalamus and midbrain, incoming nociceptive afferent stimuli to the higher brain centers from spinal cord, impulse transmission to the medulla oblongata (reticular formation) is inhibited. It is believed that the analgesic and hypnotic effects of Ketamine are due to the influence active substance on the different types 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 is able to distribute rather quickly, first in well-perfused organs, and then in tissues with reduced perfusion. Metabolized in the hepatic system. It is excreted through the kidneys in the form of conjugated metabolites.
Indications for use
Ketamine what is it? The drug is used both for mononarcosis (1 component) and for combined anesthesia, mainly in people with low level blood pressure, or if it is necessary to maintain the patient's spontaneous breathing. Most often, Ketamine is used during evacuation with massive and traumatic shock, during short-term cardiac surgery, in emergency surgery. Ketamine is prescribed for:
- cardiac catheterization ;
- endoscopic manipulations;
- dressings in otorhinolaryngology, ophthalmology and dentistry.
The drug can be used in obstetric practice.
Contraindications
- eclampsia with a severe form of circulatory decompensation;
- pronounced .
If necessary, use muscle relaxants during operations on the larynx, Ketamine is prescribed with caution. Mixing with barbiturate solutions is unacceptable due to the risk of precipitation.
Side effects
The drug has a general effect on the human body. With the introduction of the solution, a rise in blood pressure by 20-30%, an increase in heart rate, an increase in minute volume of blood, and a decrease in peripheral vascular resistance are recorded. The use of Sibazon ( ) helps reduce the stimulating effect of Ketamine on the heart. In most cases active ingredient does not inhibit the reflexes of the upper respiratory tract, does not cause bronchospasm, laryngospasm, vomiting and nausea. Respiratory depression registered with a rapid intravenous infusion of the solution. and Metacin can reduce salivation. With the introduction of the drug, hypertonicity, involuntary movements can be recorded (stopped with the introduction of tranquilizers). Possible redness skin along the vein at the injection site; upon awakening from anesthesia - prolonged disorientation and psychomotor agitation .
Application instruction of Ketamine (Way and dosage)
The solution is administered intravenously (fractional / jet) or intramuscularly. Intravenously, adults are administered 2-3 mg, intramuscularly - 4-8 mg per 1 kg of weight. Repeated administration of Ketamine allows to prolong anesthesia (speed 2 mg/kg/h). This method of administration is possible in the presence of infusion pumps or is achieved by dripping a 1% solution of Ketamine in sodium chloride solution or isotonic solution (30-60 drops per minute).
AT pediatric practice solution is used for combined anesthesia. The calculation is made according to the scheme: 4-5 mg / kg in the form of a 5% solution. Mandatory premedication required.
The drug can be used in conjunction with analgesics ( , depidolor, etc.) and antipsychotics (eg, Droperidol), however, this requires a dose reduction.
Overdose
Registered respiratory depression which requires timely artificial lung ventilation .
Interaction
Ketamine is chemically incompatible with barbiturates (a precipitate forms). The drug is able to potentiate the action of all drugs used for inhalation anesthesia . medicinal product enhances the effect of tubocurarine, but does not affect the effectiveness of succinylcholine and pancuronium.
Terms of sale
Sold only for hospitals and medical institutions, not intended for free sale.
Storage conditions
Best before date
special instructions
In the pathology of the renal system is used with caution. During 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 inhibition of the reaction and decreased attention.
Analogues
Coincidence in the ATX code of the 4th level:- Ketanest;
- Ketalar .
During pregnancy and lactation
The active ingredient passes through the placental barrier. At the moment, the safety of using Ketamine has not been established. Not recommended for pregnant women and .
Instructionon medical use
KETAMINE-BIOLEK
Tradename
Ketamine-Biolek
International non-proprietary name
Dosage form
Solution for injection 50 mg/ml, 2 ml or 10 ml
Compound
1 ml of the drug contains
active substance - ketamine hydrochloride 57.6 mg in terms of ketamine 50 mg,
inexcipients: benzethonium chloride, sodium chloride, water for injection.
Description
Clear colorless solution
Pharmacotherapeutic group
Other general anesthetics. Ketamine
ATX code N01AX03
Pharmacological properties
Pharmacokinetics
Ketamine is fat soluble. The maximum plasma concentration is observed one minute after intravenous administration and 20 (5-30) minutes after intramuscular administration. At intramuscular injection bioavailability is 93%. About 47% of ketamine binds to blood proteins. The first phase of the drug (alpha phase) lasts about 45 minutes, t 1/2 = 10-15 minutes. Clinically, the first phase is manifested by the anesthetic effect of the drug. Ketamine is distributed rapidly into
well-vascularized tissues (for example, in the brain). The concentration of Ketamine-Biolek in tissues corresponds to a two-phase open model. The cessation of the anesthetic effect occurs due to redistribution from the central nervous system in less blood-supplied peripheral tissues and biotransformation in the liver into active metabolites. Among the metabolites of ketamine, there is one that has a hypnotic effect. The half-life of the second phase (beta phase) is about 2.5 hours. 90% of metabolites are excreted through the kidneys. Ketamine crosses the placenta.
Pharmacodynamics
Ketamine-Biolek is an anesthetic agent with a pronounced analgesic effect. The drug causes the so-called dissociative anesthesia, which is described as a functional dissociation between the thalamo-neocortical and limbic systems. The analgesic effect of the drug is already manifested at a subdissociative dose and lasts longer than anesthesia. Sedative and hypnotic effects are less pronounced. in the region of the spinal cord and peripheral nerves the drug exhibits a local anesthetic effect. When using the drug muscle tone remains unchanged or may increase, so protective reflexes are usually not impaired. The seizure threshold does not decrease. Spontaneous breathing may increase intracranial pressure, which can be avoided by controlled breathing.
Since Ketamine-Biolek causes sympathicotonia, blood pressure and heart rate may increase, along with an increase in coronary blood flow in the myocardium, oxygen demand increases. Ketamine-Biolek has a negative inotropic effect and antiarrhythmic action (direct cardiac effect). Due to the antagonistic action, peripheral vascular resistance does not change. After the use of the drug, significant hyperventilation is observed, without significant deviations in the parameters of blood gases. Ketamine-Biolek relaxes the muscles of the bronchi.
Ketamine-Biolek does not affect metabolism, liver, kidneys, endocrine glands, gastrointestinal tract and blood clotting.
Indications for use
As monotherapy for short diagnostic or therapeutic interventions in childhood and in some special cases in adults
Introduction to anesthesia and its maintenance (in a reduced dose in combination with other drugs used to conduct general anesthesia especially with benzodiazepines). Can be combined with any type of local anesthesia.
Special indications for the use of Ketamine-Biolek (in monotherapy or in combination with another drug):
Administration of anesthesia in patients state of shock, with hypotension (due to the peculiarities of the action of Ketamine-Biolek on the heart and blood circulation)
Conducting anesthesia in patients in whom intramuscular administration of the drug is preferable (for example, in children)
Dosage and administration
The individual response to Ketamine-Biolek, as with other systemic anesthetics, varies depending on the dose, route of administration, and age of the patient. Therefore, the appointment of the drug should be made individually. When used in combination, the dose of the drug should be reduced.
Below are the doses for adults and children.
Adults.
Intravenous administration
An initial dose of 0.7-2 mg/kg body weight, which provides adequate surgical anesthesia for 5-10 minutes approximately 30 seconds after administration. (In patients at high risk, the elderly, or those in shock, the recommended dose is 0.5 mg/kg body weight.)
Intramuscular administration
An initial dose of 4-8 mg/kg body weight, which provides surgical anesthesia lasting 12-25 minutes a few minutes after administration.
Intravenous drip
500 mg of the drug + 500 ml of 5% glucose solution or 0.9% sodium chloride solution for injection / infusion. Recommended starting dose: 2-6 mg/kg body hour.
Maintenance of anesthesia
If necessary, half of the initial dose or the initial dose can be re-administered intramuscularly or intravenously.
The appearance of nystagmus, a motor reaction to irritations indicate an insufficiency of anesthesia, therefore, in this case, a second dose may be required. However, involuntary movements of the limbs can occur regardless of the depth of anesthesia!
Children.
Intramuscular for induction anesthesia various types combined anesthesia is administered once at the rate of 4-5 mg / kg in the form of a 5% solution (after appropriate premedication). For the main anesthesia, the doses of ketamine for intramuscular administration are determined depending on the body weight and age of the children: newborns and infants 8-12 mg / kg, children from 1 to 6 years old - 6-10 mg / kg, 7-14 years old - 4 -8 mg/kg.
Intravenously ketamine is used at a dose of 2-3 mg/kg. Maintenance of anesthesia is carried out by repeated injections of 3-5 mg / kg intramuscularly, or
0.5-1 mg / kg intravenously by stream, or by continuous intravenous infusion by drip injection of a 0.1% solution of the drug at 30-60 drops per minute.
General anesthesia in children with intramuscular injection occurs after 2-6 minutes, with intravenous - after 15-60 seconds, the duration of action is 15-30 minutes and 5-15 minutes, respectively.
Ketamine can be used in combination with neuroleptics (droperidol, etc.) and analgesics (fentanyl, promedol, dipidolor, etc.). In these cases, the dose of ketamine is reduced.
Side effects
When assessing the frequency of occurrence of various adverse reactions the following criteria were used: very frequent - more than 10%; frequent - 1‑10%; infrequent - 0.1-1%; rare - 0.01-0.1%; very rare - less than 0.01%.
Often:
Increased heart rate. The cardiac stimulating effect of ketamine can be prevented by preliminary intravenous administration of diazepam at a dose of 0.2-0.25 mg/kg of body weight
Raise blood pressure. The maximum increase in blood pressure (20-25%) is observed a few minutes after the intravenous administration of the drug, but after 15 minutes the blood pressure returns to its original values.
With rapid administration or overdose - respiratory depression or cessation
An increase in skeletal muscle tone can cause tonic and clonic movements, which do not indicate a decrease in the depth of anesthesia, and therefore do not require the introduction of an additional dose of the drug.
Rarely:
During the period of regaining consciousness, there may be vivid dreams, visual hallucinations, emotional disturbances, delirium, prolonged disorientation, psychomotor agitation, a feeling of confusion. These phenomena are observed less often in patients younger than 15 years and older than 65 years.
Diplopia, nystagmus, moderate increase in intraocular pressure
Loss of appetite, nausea, vomiting, drooling
Transient erythema and/or measles rash
Pain, rash at the injection site
laryngospasm
Bradycardia, arrhythmia
Hypotension
ATindividual cases:
Anaphylactoid reaction
With repeated use over a short period, especially in young children, tolerance to the drug was noted. In these cases, the desired effect can be achieved by an appropriate dose increase.
Contraindications
Hypersensitivity to active ingredient or to any of the components of the drug
Patients with severe or poorly controlled hypertension (BP >180/100 mm Hg at rest), patients in whom an increase in blood pressure may worsen the condition (congestive heart failure, severe cardiovascular disorders)
traumatic brain injury, intracranial hemorrhage, stroke
brain tumors
Eclampsia or preeclampsia
Uncompensated hyperthyroidism
History of seizures, increased intracranial pressure
Mental illness (schizophrenia, acute psychosis)
Epilepsy and epileptic syndrome
Alcoholism
Drug Interactions
Ketamine-Biolek potentiates the neuromuscular effect of barbiturates, opiates, and also enhances the action of tubocurarine and ergometrine, but does not affect the action of pancuronium and succinylcholine.
Barbiturates and inhalants for general anesthesia, fluorinated hydrocarbons (halothane, enflurane, isoflurane, methoxyflurane) increase the duration of action of Ketamine-Biolek.
Sleeping pills (especially benzodiazepine derivatives) or antipsychotics increase the duration of the drug and reduce the likelihood of side effects.
During therapy with thyroid hormones, an increase in blood pressure and tachycardia can be observed.
When used together with aminophylline, the seizure threshold may decrease. Ketamine-Biolek is compatible with other anesthetics and muscle relaxants. Ketamine-Biolek is pharmaceutically incompatible with barbiturates and diazepam (precipitation), so the drugs cannot be mixed in the same syringe or infusion.
special instructions
The drug can be combined with any type of local anesthesia.
The drug should be prescribed by a specialist anesthesiologist in a hospital setting.
As with the use of other general anesthetics, when using Ketamine-Biolek, it is necessary to prepare tools for resuscitation. Within 6 months after an attack of unstable angina and myocardial infarction, with increased intracranial pressure, glaucoma or penetrating eye injury Ketamine-Biolek is prescribed with caution, after assessing the benefit-risk ratio.
Intravenous Ketamine-Biolek should be administered slowly (within 1 minute). Rapid administration of the drug can lead to respiratory depression and a sharp increase in blood pressure.
In patients with hypertension or heart failure, continuous monitoring of cardiac function is necessary during anesthesia.
Since pharyngeal reflexes are usually preserved with Ketamine-Biolek monotherapy, mechanical irritation of the pharynx should be avoided. Interventions on the larynx, pharynx or trachea require a combination of Ketamine-Biolek with muscle relaxants and careful control of breathing.
In surgical interventions involving the visceral tracts pain sensitivity, it may be necessary to introduce other analgesics.
For obstetric interventions that require complete relaxation of the muscles of the uterus, the administration of ketamine in monotherapy is not indicated.
For diagnostic or therapeutic interventions on the organ of vision, the use of local analgesics is not indicated.
Ketamine should be used with extreme caution in alcohol intoxication.
During the period of recovery from anesthesia, acute delirium may occur. This reaction can be prevented by administering benzodiazepines or reducing verbal, tactile, and visual stimuli. But this does not exclude monitoring of vital parameters.
When using Ketamine-Biolek on an outpatient basis, the patient can be released only after full recovery of consciousness, accompanied by an adult.
Pregnancy and lactation
The safety of using Ketamine during pregnancy has not been established. Ketamine quickly crosses the placenta. During pregnancy, it can be used only after an assessment of the benefit-risk ratio. For obstetric anesthesia, smaller doses should be used. A dose of 2 mg/kg body weight or more may lead to respiratory depression in the newborn. Use in this category of patients is not recommended.
There is no data on whether Ketamine-Biolek passes into breast milk.
Features of the effect of the drug on the ability to drive vehicle or potentially dangerous machinery.
Within 12 hours after the use of ketamine, patients should refrain from driving vehicles and other potentially dangerous species activities.
Overdose
Symptoms: respiratory depression up to apnea.
Treatment: artificial ventilation of the lungs until adequate spontaneous breathing is restored.
Release form and packaging
2 ml in ampoules or 10 ml in glass vials, vials sealed with rubber stoppers and rolled up with aluminum caps.
10 ampoules, together with instructions for medical use in the state and Russian languages and a scarifier, are packed in a pack. When packing ampoules with a colored break ring, the insertion of an ampoule scarifier is excluded.
1 or 10 bottles, together with instructions for medical use in the state and Russian languages, are packed in a cardboard box.
Storage conditions
Store in a place protected from light, at a temperature not exceeding 25 ° C.
Keep out of the reach of children!
Shelf life
Do not use after the expiry date stated on the packaging!
Terms of dispensing from pharmacies
On prescription
Manufacturer
Registration certificate holder
PJSC "PHARMSTANDART-BIOLEK", Ukraine
Address of the organization accepting claims from consumers on the quality of products on the territory of the Republic of Kazakhstan
PJSC "PHARMSTANDART-BIOLEK", Ukraine
61070, Ukraine, Kharkiv, Pomerki
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Name:
Ketamine (Ketaminum)
Pharmacological
action:
Means for non-inhalation anesthesia.
With a single intravenous injection of ketamine, the narcotic effect occurs 30-60 seconds after administration and lasts 5-10 minutes (up to 15 minutes).
With the / m administration of ketamine at a dose of 4-8 mg / kg, the effect occurs after 2-4 minutes (up to 6-8 minutes) and lasts an average of 12-25 minutes (up to 30-40 minutes).
Ketamine causes a pronounced analgesic effect (up to 2 hours), but insufficient muscle relaxation. With the introduction of ketamine, pharyngeal, laryngeal and cough reflexes, independent adequate pulmonary ventilation are preserved.
Pharmacokinetics
Ketamine is a lipophilic compound and, therefore, is rapidly distributed to organs well supplied with blood, incl. in the brain, and then redistributed to tissues with reduced perfusion.
Metabolized in the liver.
T1 / 2 is 2-3 hours.
It is excreted by the kidneys mainly in the form of conjugated metabolites.
Indications for
application:
For mononarcosis and combined anesthesia, especially in patients with low blood pressure, or if it is necessary to maintain spontaneous breathing, or for mechanical ventilation with respiratory mixtures that do not contain nitrous oxide;
- in emergency surgery and at the stages of evacuation, in particular in patients with traumatic shock and blood loss (due to the rapid introduction into anesthesia and the absence of respiratory depression and a cardiostimulating effect);
- in various surgical operations (including cardiac surgery);
- with combined intravenous anesthesia;
- in endoscopic procedures, cardiac catheterization, minor surgical procedures, dressings, including in dental, ophthalmological and otorhinolaryngological practice.
There is evidence of the successful use of ketamine in obstetric practice for caesarean section.
Mode of application:
Inject Ketamine intravenously(jet at once or fractional and drip) or intramuscularly.
Adults administered intravenously at the rate of 2 - 3 mg, intramuscularly - 4 - 8 mg per 1 kg of body weight.
To maintain anesthesia, ketamine injections are repeated (0.5–1 mg/kg intravenously or 3 mg/kg intramuscularly).
Maintenance of general anesthesia by continuous intravenous infusion of ketamine is achieved by its administration at a rate of 2 mg/kg per hour.
This method is carried out using infusion pumps or by dripping a 0.1% solution of ketamine in an isotonic solution of glucose or sodium chloride (30-60 drops per minute).
In children, Ketamine is used for induction anesthesia for various types of combined anesthesia.
Intramuscularly administered once at the rate of 4-5 mg / kg in the form of a 5% solution (after appropriate premedication).
For basic anesthesia, a 5% solution is administered intramuscularly or a 1% solution intravenously in a jet at once or a 0.1% solution drip (at a rate of 30-60 drops per minute).
Intramuscularly administered newborns and children infancy
at the rate of 8 - 12 mg / kg, children aged 1 to 6 years- 6-10 mg/kg, 7 to 14 years old- 4 - 8 mg/kg.
Intravenously administered at the rate of 2-3 mg / kg.
Anesthesia is maintained by repeated injections of 3–5 mg/kg intramuscularly or 1 mg/kg intravenously by bolus. Anesthesia can be maintained by drip intravenous injection of a 0.1% solution of ketamine (30-60 drops per minute).
Ketamine can be used in combination with neuroleptics (droperidol, etc.) and analgesics (fentanyl, promedol, depidolor, etc.). In these cases, the dose of ketamine is reduced.
Side effects:
When using ketamine, it is necessary to take into account the features of its general action on the body.
A drug usually causes an increase in blood pressure(by 20 - 30%) and increased heart rate with an increase in cardiac output; peripheral vascular resistance decreases.
Stimulation of cardiac activity can be reduced by the use of diazepam (sibazon).
Usually, ketamine does not depress respiration, does not cause laringo - and bronchiospasm, does not depress reflexes from the upper respiratory tract A: Nausea and vomiting usually do not occur.
With fast intravenous administration possible respiratory depression.
To reduce salivation, a solution of atropine or metacin is administered.
The use of ketamine may be accompanied by involuntary movements, hypertonicity, hallucinatory phenomena. These effects are prevented or removed by the introduction of tranquilizers, as well as droperidol.
When administered intravenously ketamine solution is sometimes possible pain and redness of the skin along the vein, upon awakening - psychomotor agitation and relatively prolonged disorientation.
Contraindications:
Violations of cerebral circulation;
- arterial hypertension;
- angina pectoris and heart failure in the decompensation phase;
- preeclampsia and eclampsia;
- epilepsy in childhood.
Safety the use of ketamine during pregnancy and lactation has not been established. Use in this category of patients is not recommended.
Carefully used in patients with kidney disease. In operations on the larynx and pharynx, ketamine is used in combination with muscle relaxants.
Influence on the ability to drive vehicles and control mechanisms
After using ketamine for at least 24 hours, patients should refrain from driving vehicles and other potentially hazardous activities.
Ketamine (as hydrochloride) (ketamine)
Composition and form of release of the drug
5 ml - bottles (5) - packs of cardboard.
pharmachologic effect
Means for non-inhalation anesthesia. With a single intravenous injection of ketamine, the narcotic effect occurs 30-60 seconds after administration and lasts 5-10 minutes (up to 15 minutes). With the / m administration of ketamine at a dose of 4-8 mg / kg, the effect occurs after 2-4 minutes (up to 6-8 minutes) and lasts an average of 12-25 minutes (up to 30-40 minutes). Ketamine causes a pronounced analgesic effect (up to 2 hours), but insufficient muscle relaxation. With the introduction of ketamine, pharyngeal, laryngeal and cough reflexes, independent adequate pulmonary ventilation are preserved. Metabolized in the liver.
Pharmacokinetics
Ketamine is a lipophilic compound and, therefore, is rapidly distributed to organs well supplied with blood, incl. in the brain, and then redistributed to tissues with reduced perfusion. Metabolized in the liver. T1 / 2 is 2-3 hours. It is excreted by the kidneys mainly in the form of conjugated metabolites.
Indications
For induction and basic anesthesia, for short-term surgical interventions requiring and not requiring muscle relaxation, for painful instrumental and diagnostic manipulations, for transporting patients, for treating a burn surface.
Contraindications
Cerebral circulation disorders, arterial hypertension, angina pectoris and insufficiency in the decompensation phase, preeclampsia and eclampsia, epilepsy in childhood.
Dosage
Depending on the indications, the age of the patient, the clinical situation, drugs used for premedication, a single dose for intravenous administration is 0.5-4.5 mg/kg, for intramuscular administration - 4-13 mg/kg.
Side effects
From the side of the cardiovascular system: increased blood pressure, tachycardia.
From the digestive system: hypersalivation.
From the side of the central nervous system: psychomotor agitation and hallucinations in the period of recovery from anesthesia.
From the respiratory system: shortness of breath, respiratory depression.
Local reactions: extremely rarely, pain and hyperemia along the vein is possible at the injection site.
drug interaction
Ketamine potentiates the action of drugs for inhalation anesthesia. Enhances the effect of tubocurarine, but does not change the effect of pancuronium and succinylcholine.
Ketamine is chemically incompatible with barbiturates due to the formation of a precipitate.
special instructions
Use with caution in patients with kidney disease. In operations on the larynx and pharynx, ketamine is used in combination with
