[Ketamine: the past 30 years and its future].

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Radovanovic D, Pjevic M

[Ketamine: the past 30 years and its future].

Med Pregl. 2003 Sep-Oct;56(9-10):439-45.

PubMed ID

14740534 [ View in PubMed

]

Abstract

INTRODUCTION: There are two isomers of ketamine: S(+) ketamine and R(-) ketamine. Effects of this drug are mediated by N-methyl-D-aspartate (NMDA), opioid and muscarinic receptors. PHARMACOKINETICS: Due to its high lipid solubility and low protein binding, ketamine is extensively distributed in the body. Ketamine metabolism is mediated by hepatic microsomal enzymes. EFFECTS ON BODY SYSTEMS: Ketamine causes increased intracranial pressure, bronchodilation and stimulation of cardiovascular system. CLINICAL USE: ANESTHESIA: It is used for premedication, sedation, induction and maintenance of general anesthesia. Ketamine is an ideal anesthetic agent for trauma victims, patients with hypovolemic and septic shock, patients with pulmonary diseases. ANALGESIA: Even subanesthetic doses of ketamine have analgesic effects, so ketamine is also recommended for postoperative analgesia. Recent results show that ketamine is not always effective as an analgesic in treatment of chronic pain and that some side effects limit its use in patients with chronic pain. INTENSIVE CARE: Combination of ketamine and midazolam can be very useful and safe for sedation and pain relief in intensive care patients, especially during ventilator management. Ketamine may be the anesthetic of choice for painful procedures in intensive care units.

DrugBank Data that Cites this Article

Drug Targets

Drug	Target	Kind	Organism	Pharmacological Action	Actions
Ketamine	Glutamate receptor ionotropic, NMDA 3A	Protein	Humans	Yes	Antagonist	Details