Ketamine

Question 1

What is the mechanism of action of Ketamine?

Answer 1

●Blocks N-methyl-d-aspartate (NMDA) receptors preventing excitation of neurotransmitters in the brain.
●Low doses cause analgesia.
●Larger doses cause amnesia and dissociation.
●High doses cause anaesthesia.

Question 2

What are the indications for Ketamine?

Answer 2

●Severe pain not controlled with opiates.
●Dissociation.
●Acute behavioural disturbance causing a severe to immediately life-threatening risk to safety.
●Asthma with severe agitation that is impairing the ability to safely provide treatment or transport.
●RSI.
●Significant movement during CPR causing disruption of CPR.

Question 3

What are the contraindications of Ketamine?

Answer 3

●Known severe allergy.
●Less than 1 year old.

Question 4

What are the cautions for Ketamine? (5)

Answer 4

●ALOC (can reduce LOC).
●Signs of shock (May worsen shock).
●Myocardial Ischaemia (may increase 02 demand).
●Concurrent administration with opiates or Midazolam (will prolong/increase effects).
●75 years old or older (will prolong/increase effects).