Ketamine

Question 1

Trade name

Answer 1

Ketaset

Question 2

Class

Answer 2

Anesthetic - dissociative

Question 3

Mechanism of action

Answer 3

rapid acting agent who’s pharmacological action is characterized by:
-Profound analgesia
-Normal pharyngeal-laryngeal reflexes
-Mild cardiac stimulation and respiratory depression
Its pharmacological action is characterized by profound analgesia, normal pharyngeal-laryngeal reflexes, mild cardiac stimulation and respiratory depression

Question 4

Indications

Answer 4

The sole anesthetic agent for procedures that do not require skeletal muscle relaxation

Question 5

Contraindications

Answer 5

Ketamine is contraindicated in those whom a significant elevation of blood pressure would constitute a serious hazard.

Question 6

Relative contraindications

Answer 6

Hypovolemia, dehydration, CAD, CHF, Hepatic impairment, alcoholism, substance abuse

Question 7

Adverse effects

Answer 7

Election of heart rate and blood pressure or bradycardia (rare) hypersalivation, laryngospasm (rare)

Question 8

Incompatabilites / Drug interactions

Answer 8

All drugs - flush line before and after administration

Question 9

Routes

Answer 9

IV/IO over 1 min

Question 10

Onset

Answer 10

30 sec, duration of 5-10 min

Question 11

Adult dose

Answer 11

RSI: 1-2 mg/kg

Post sedation: 1 mg/kg repeat every 20 min

Question 12

Pediatric dose

Answer 12

RSI: Ketamine 1-2 mg/kg

Post sedation 1mg/kg repeat every 20 min

Question 13

Obstetrical dose

Answer 13

RSI: 1-2 mg/kg

Post sedation: 1 mg/KG repeat every 20 min

Question 14

Special considerations

Answer 14

Ketamine should not be used alone in procedures of the pharynx, larynx (due to enact Gag reflex)
Mechanical stimulation of the pharynx should be avoided, whenever possible, if ketamine is used alone. Muscle relaxants, with proper attention to respiration, may be required in both of these instances
Respiratory depression may occur with over dosage or too rapid a rate of administration
Bronchodilation makes ketamine a favored induction agent for RSI during status asthmatics

Question 15

Protocols used

Answer 15

A-2 allergic reaction 
A-4 Asthma
A-9 Bradyarrythmias
A-11 V-tach with pulse- unstable
A-12 PSVT Unstable
A-14 emphysema/COPD
B-10 Pediatric allergic RXN
B-11 Pediatric Asthma
C-7 Orthopedic Injuries
E-17 RSI
E-18 Intranasal medication device
E-19 sedation/pain