F-19.5.-Ketamine

Question 1

Class of medication of ketamine.

Answer 1

Dissociative hypnotic

• selective antagonist to NMDA-R
• prevents opening of ligand gated NMDA neurons
• May also act on delta, kappa, and mu opioid receptors, unsure yet (does have analgesic properties at low dose)

Question 2

For what procedures may ketamine be admininstered?

Answer 2

• Pre-cardioversion sedation

- Pre-transcutaneous pacing sedation

Question 3

For what medical emergencies may ketamine be admininstered?

Answer 3

Behavioral emergencies

Question 4

Medical control must be contacted prior to co-administration of ketamine with ____.

Answer 4

Opioids

- Ketamine and opioids have a synergistic effect on respiratory depression.

Question 5

Ketamine may be used in patients with hypotension/respiratory depression. Why?

Answer 5

Ketamine also stimulates the release of catecholamines (epinephrine and norepinephrine), which counteracts hypotension/respiratory depression.

Question 6

Contraindications of ketamine

Answer 6

• hypersensitivity

Question 7

Cautions of ketamine

Answer 7

• ETOH use
• advanced age
• cardiac disease (why? epi/norepi release?)
• significant tachycardia/hypertension (epi/NE release?)
• schizophrenia
• Pregnancy class C (benefits must be greater than risk)

Question 8

Dose of ketamine and adults over 6 months?

Answer 8

2.5-5mg/kg IV with rounding of dose

Question 9

Max dose of ketamine?

Answer 9

500 mg