Ketamine Flashcards
1
Q
class
A
non-barbiturate induction agent
2
Q
structure
A
phenylcyline derivative (PCP)
3
Q
mech of action
A
blocks NMDA receptor, decreases ion influx and neurotransmission.
opioid receptor agonist
muscarinic antagonist
4
Q
pharmacokinetics
PB
LS
Vd
A
PB: 12%
highly lipid soluble, crosses BBB
Vd: 3 L/kg
5
Q
elimination
A
metabolized by CYP450 to norketamine, hydrolized and conjugated to water soluble compound, excreted by urine.
some eliminated unchanged in urine/feces
hepatic blood flow alters clearance
6
Q
onset
doa
T1/2
A
onset: 30 sec
doa: 10 min
T1/2: 2-3 hrs
7
Q
active metabolite
A
Norketamine (20-30% active)
8
Q
side effects
A
INCREASED CBF, CMRO2, ICP, IOP emergence delirium hallucinations myoclonus increased SNS response b/c it inhibits NE uptake increased SVR, BP, HR direct myocardial depressant
bronchodilation
increased saliva
potentiates NMB
9
Q
contraindications
A
psych disorders head/eye injury/surgery CAD HTN/PHTN pheochromocytoma
10
Q
dose
A
induction: 0.5-2 mg/kg IV
sedation: 0.2-0.5 mg/kg/hr
maintenance 1-2 mg/kg/hr IV; 5-10 mg/kg IM/PR
