Ketamin G.L. (Ketamine)

Ketamine acts as an NMDA receptor antagonist and is used in clinical settings that require rapid induction of anesthesia, sedation, or analgesia.

• Induction of anesthesia: provides rapid loss of consciousness for surgical procedures.
• Sedation: enables procedural sedation with analgesic properties for diagnostic or minor surgical interventions.
• Analgesia: offers effective pain relief in acute severe pain or as an adjunct in trauma management.

• Ketamine binds to the phencyclidine site of the NMDA receptor as a non‑competitive antagonist, blocking calcium influx and reducing excitatory neurotransmission. This inhibition disrupts synaptic transmission in the central nervous system, producing dissociative anesthesia, analgesia, and amnesia while preserving airway reflexes and cardiovascular stability.

Ketamine may cause a range of adverse reactions, varying from mild to severe.

Common Side Effects

• Hypertension: transient increase in blood pressure.
• Tachycardia: elevated heart rate.
• Nausea: feeling of sickness.
• Vomiting: expulsion of stomach contents.
• Dizziness: sensation of light‑headedness.
• Visual disturbances: blurred or altered vision.

Serious or Rare Side Effects

• Respiratory depression: reduced breathing effort.
• Emergence delirium: agitation or confusion on awakening.
• Severe hypertension: marked rise in blood pressure.
• Cardiac arrhythmias: irregular heart rhythms.
• Psychotic reactions: hallucinations or severe agitation.
• Allergic reactions: rash, itching, or anaphylaxis.

Ketamine should be administered with careful clinical oversight and appropriate monitoring.

• Patient assessment: evaluate cardiovascular and respiratory status before use.
• Contraindications: avoid in individuals with known hypersensitivity to ketamine.
• Monitoring: maintain continuous observation of vital signs and level of consciousness.
• Drug interactions: consider additive effects with other central nervous system depressants.
• Pregnancy and lactation: use only if benefits outweigh potential risks.
• Store at ambient temperature: keep in the original container, protect from light and moisture.

Ketamine can interact with several medications, requiring vigilance to avoid adverse outcomes.

Major Interactions (Avoid)

• CNS depressants (e.g., benzodiazepines, opioids): may cause profound sedation or respiratory depression.
• Monoamine oxidase inhibitors: increase risk of severe hypertension.
• Sympathomimetic agents: can precipitate hypertensive crises.
• Alcohol: enhances sedative effects and respiratory depression.

Moderate Interactions (Monitor Closely)

• Antihypertensive drugs: additive blood pressure lowering.
• Anticholinergic agents: may exacerbate tachycardia.
• Antiepileptic drugs: potential alteration of seizure threshold.
• Inhalational anesthetics: may require dose adjustments.