Ketamin Sine Panpharma (Ketamine)

Ketamine is a dissociative anesthetic that acts on the central nervous system to facilitate anesthesia and sedation.

• Induction of anesthesia: provides rapid loss of consciousness for surgical procedures.
• Procedural sedation: enables safe sedation for diagnostic or minor interventions.
• Analgesic adjunct: used to supplement pain control in refractory acute pain situations.

• Ketamine exerts its effect primarily as a non‑competitive antagonist of the N‑methyl‑D‑aspartate (NMDA) receptor. By blocking the NMDA‑mediated excitatory neurotransmission, it reduces neuronal firing in the spinal cord and brain, leading to dissociation, analgesia, and amnesia. Additional actions at opioid receptors, monoaminergic pathways, and voltage‑gated calcium channels contribute to its anesthetic and analgesic profile. The blockade also diminishes central sensitization, which helps prevent the development of hyperalgesia during surgery.

Ketamine may produce a range of adverse reactions, varying from mild to severe, that should be monitored during and after administration.

Common Side Effects

• Hypertension: transient increase in blood pressure.
• Nausea: feeling of sickness.
• Salivation: increased oral secretions.

Serious or Rare Side Effects

• Respiratory depression: reduced breathing effort requiring support.
• Psychotomimetic reactions: vivid hallucinations or delirium.
• Allergic reaction: rash, urticaria, or anaphylaxis.

Ketamine requires careful monitoring and specific precautions to ensure patient safety.

• Cardiovascular monitoring: observe blood pressure and heart rate due to possible increases.
• Airway management: be prepared for airway support in case of respiratory depression.
• Psychiatric assessment: monitor for emergence phenomena or hallucinations during recovery.
• Contraindications: avoid in patients with known hypersensitivity to ketamine.
• Drug interactions: review concomitant medications that affect CNS or cardiovascular function.
• Store at ambient temperature: keep in original container, protect from light and moisture.

Ketamine can interact with several drug classes, necessitating awareness of potential additive effects.

Major Interactions (Avoid)

• Benzodiazepines: may blunt anesthetic effect and require dose adjustment.
• Sympathomimetic agents: can exacerbate hypertension and tachycardia.
• Monoamine oxidase inhibitors: increase risk of hypertensive crisis.

Moderate Interactions (Monitor Closely)

• Opioids: additive respiratory depression may occur.
• Alcohol: enhances sedative effects and may increase emergence reactions.
• Anticholinergics: may affect heart rate variability.