Ketamine (Ketalar)

Question 1

Ketamine
Classification

Answer 1

Sedative
Hypnotic
Analgesic
Anesthetic

Question 2

Ketamine
Mechanism of Action

Answer 2

Non-competitive NMDA-R antagonist which inhibits glutamate binding and subsequent depolarization of afferent neurons which prevents transmission of pain impulses and generates dissociative state

Question 3

Ketamine
Onset of Action

Answer 3

<1 min IV
<5 min IM

Question 4

Ketamine
Peak Effects

Answer 4

varies

Question 5

Ketamine
Duration of Effects

Answer 5

5-15 min IV
20-30 min IM

Question 6

Ketamine
Half-life

Answer 6

1-2 hrs

Question 7

Ketamine
Indications/Field Use

Answer 7

Induction agent for RSI
Post-Intubation sedation
Excited delirium
Pain management

Question 8

Ketamine
Contraindications

Answer 8

Hypersensitivity
Patient <3mos of age
Glaucoma

Question 9

Ketamine
Side Effects/Adverse Reactions

Answer 9

Hypersalivation
Tachycardia
HTN
Increased ICP
Dysrhythmia
N/V
Emergence reaction

Question 10

Ketamine
Adult Dose

Answer 10

-RSI 2mg/kg slow IV/IO
-Sedation 1mg/kg IV/IO, q 5-15min as needed
-Excited delirium 4mg/kg IM (max single dose 500mg; may give additional 100mg IM in 5-10 min) or 1mg/kg IV/IO over 2 min (may give additional 0.5-1mg/kg IV/IO in 5 min, max total 2mg/kg)
-Pain management 0.3mg/kg IV/IO/IM (max 30mg)

Question 11

Ketamine
Pediatric Dose

Answer 11

-RSI 1-2mg/kg IV/IO
-Pain management 0.5-2 mg/kg (not in CT protocols)

Question 12

Ketamine
Precautions

Answer 12

-Consider prophylactic administration of anti-emetic
-Purposeless tonic-clonic movement does not indicated need for additional sedation
-Consider premedication with atropine for hypersalivation in pediatric patients

Question 13

Ketamine
Drug-drug interactions

Answer 13

Prolonged recovery time when given with barbituates or opiates