Ketamine Flashcards

1
Q

What is Ketamine and its primary use in medicine?

A

Ketamine is an anesthetic agent used for its dissociative anesthesia, analgesia, and hemodynamic stability, especially useful in emergency, pediatric, and psychiatric settings.

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2
Q

Describe the dissociative anesthesia provided by Ketamine.

A

Ketamine induces a unique state where the patient remains unconscious but maintains spontaneous respiration, suitable for scenarios where mechanical ventilation is undesired.

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3
Q

How does Ketamine provide analgesia?

A

Ketamine’s strong analgesic properties are effective at sub-anesthetic doses for acute and chronic pain management, owing to its NMDA receptor antagonism.

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4
Q

Explain Ketamine’s impact on cardiovascular stability.

A

Ketamine stimulates the sympathetic nervous system, increasing blood pressure and heart rate, beneficial in hypotensive or shock states.

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5
Q

Discuss Ketamine’s bronchodilatory effects.

A

Ketamine induces bronchodilation, making it advantageous for patients with asthma or other respiratory conditions by reducing the risk of bronchospasm.

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6
Q

Why is Ketamine suitable for pediatric anesthesia?

A

Due to its rapid onset, short duration, and minimal respiratory depression, Ketamine is effectively used in pediatric sedation and anesthesia.

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7
Q

What psychiatric applications does Ketamine have?

A

Low doses of Ketamine show rapid antidepressant effects in treating severe depression and suicidal ideation, offering a novel approach in psychiatry.

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8
Q

Detail Ketamine’s mechanism of action.

A

Ketamine blocks NMDA receptors, inhibiting glutamate’s excitatory effects, leading to dissociation, analgesia, and potentially rapid antidepressant effects.

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9
Q

How does Ketamine affect cerebral functions?

A

Ketamine increases cerebral blood flow and oxygen consumption, considerations crucial in neurosurgical and critically ill patients.

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10
Q

Describe Ketamine’s pharmacological profile.

A

As a phencyclidine derivative and NMDA antagonist, Ketamine is supplied as a racemic mixture, inducing dissociation, analgesia, and amnesia.

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11
Q

What side effects are associated with Ketamine use?

A

Ketamine may cause nystagmus, increased intraocular pressure, maintain reflexes, and lead to psychotomimetic effects like hallucinations or delirium.

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12
Q

Address Ketamine’s utility in low-resource settings.

A

Its versatility in administration routes (IV, IM, oral) makes Ketamine valuable in settings lacking advanced medical equipment.

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13
Q

What are the anti-inflammatory effects of Ketamine?

A

Ketamine inhibits inflammatory mediators like TNF-alpha and IL-6, contributing to its anti-inflammatory effects.

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14
Q

Discuss the metabolic fate of Ketamine.

A

Ketamine is metabolized to norketamine, which retains 20-30% of Ketamine’s activity, and further metabolism affects its analgesic efficacy and side effects.

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15
Q

Explain Ketamine’s effects on pulmonary compliance.

A

Ketamine increases pulmonary compliance and decreases resistance, acting as a potent bronchodilator and making it a good induction agent for asthmatic patients.

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16
Q

How does Ketamine influence the sympathetic nervous system?

A

Ketamine stimulates the sympathetic nervous system and inhibits norepinephrine reuptake, contributing to its cardiovascular effects.

17
Q

What considerations should be taken with repeated Ketamine doses?

A

Repeated Ketamine use can lead to tolerance, hepatic enzyme induction, and uncover direct myocardial depressant effects in certain conditions.

18
Q

Detail the precautions with Ketamine concerning ocular effects.

A

Ketamine may increase intraocular pressure, requiring caution in patients with glaucoma or eye injuries.

19
Q

How does Ketamine maintain reflexes during anesthesia?

A

Patients under Ketamine maintain cough, corneal, and swallow reflexes, differentiating it from other anesthetics.

20
Q

Discuss Ketamine’s role in inducing a catatonic state.

A

Ketamine can induce a catatonic state where the patient appears conscious but is unable to respond to sensory stimuli, characterized by eye opening, swallowing, and muscle contracture.

21
Q

Address the issue of increased salivation with Ketamine.

A

Ketamine increases lacrimation and salivation, which can increase the risk of laryngospasm, often managed by premedication with anticholinergic agents.

22
Q

Alpha-adrenergic and beta-adrenergic antagonists properties?

A

Alpha-adrenergic and beta-adrenergic antagonists may unmask the direct myocardial depressant effects of ketamine.

23
Q

Effects of depleted catecholamine stores ?

A

Sympathetic blockade or depleted catecholamine stores may unmask the direct myocardial depressant effects of ketamine