ketAMINE Flashcards
Classification
ketAMINE
- Sedative
- Analgesic
- General anaesthetic
INDICATIONs
ketAMINE
[PCP]
- mod-severe pain assoc. w/ trauma
cliniCALL REQUIRED for
- peds 5-12y/o
- palliative pt
- mod-severe pain 2nd non-traumatic back pain
- mod-severe pain assoc. abdo pain//renal colic
- for induction and maintenance of general anesthesia
[ACP]
- analgesia
- induction of sedation prior to intubation
- procedural sedation
- severe agitation/excited delirium syndrome (ExDS)
CONTRAINDICATIONs
ketAMINE
- hypersensitivity
- UNABLE to MANAGE ADVERSE EFFECTs
- conditions where elevated BP may be harmful
PCP - not for sedation & <5 y/o
ACP - <6 months
Dosage - Adult
ketAMINE
[PCP]
0.75mg/kg IN
repeat x 1 @20mins NEW 0.5mg/kg
MAX single dose 100mg
PCPs require ketamine endorsement
Dosage - Pediatric
ketAMINE
[PCP] - cliniCALL - REQUIRED
1.5mg/kg IN
repeat x 1 @20mins NEW 1mg/kg
MAX single dose 50mg
PCPs require ketamine endorsement
Pharmacodynamics
ketAMINE
- noncompetitive NMDA receptor antagonist thta blocks glutamate
- LOW (subanesthetic) doses = analgesia // modulates central sensitization // hyperalgesia // opioid tolerance // reduces polysynaptic spinal reflexes
Pharmacokinetics
ketAMINE
- IN
onset - 5-10mins
peak - 20 mins
duration - 45mins
ADVERSE EFFECTs
ketAMINE
- Emergence phenomenon (confusion, delirium, excitement, hallucinations)
- Laryngospasm (<1%)
- Tachycardia, hypertension (>10%)
- Bradycardia and hypotension (1-10%)
- Anaphylaxis (<1%)
- Hypersalivation (<1%)
Extreme muscle rigidity/tone (<1%) - Nystagmus, increased intraocular pressure
- Apnea, respiratory depression ( rare, transient reaction w/ rapid IV bolus dose
- Erythema, morilliform rash, rash at injection site
*treat emergence reactions w/ midazolam as required
Warnings // Precautions
ketAMINE
- severe hypertension (SBP >180)
- SAH // epidural hematoma with severe HTN
- myocardial ischemia, cardiac arrhythmias
SAH - subarachnoid hemorrhage
