{"id":4098,"date":"2025-03-31T18:11:57","date_gmt":"2025-03-31T18:11:57","guid":{"rendered":"https:\/\/kidneydiseaseclinic.net\/kdc\/ketamine-txt\/"},"modified":"2025-03-31T18:11:57","modified_gmt":"2025-03-31T18:11:57","slug":"ketamine-txt","status":"publish","type":"post","link":"https:\/\/kidneydiseaseclinic.net\/kdc\/ketamine-txt\/","title":{"rendered":"Ketamine.txt"},"content":{"rendered":"

Ketamine <\/h1>\n

CLINICAL USE <\/H3>
\nAnaesthetic agent, analgesic

DOSE IN NORMAL RENAL FUNCTION <\/H3>All doses are expressed as the base: 1.15 mg ketamine hydrochloride \u22611 mg of baseAnaesthesia: IM Short procedures: initially 6.5\u201313 mg\/ \u2014kg (10 mg\/kg usually gives 12\u201325 minutes of surgical anaesthesia)Painful diagnostic manoeuvres: initially \u20144 mg\/kgIV Injection: Initially 1\u20134.5 mg\/kg over at least \u201460 seconds (2 mg\/kg usually gives 5\u201310 minutes of surgical anaesthesia)IV Infusion: Induction total dose of \u20140.5\u20132 mg\/kg; maintenance 10\u201345 mcg\/kg\/min; adjust rate according to response if infusion requiredAnalgesia: IM: 1.5\u20132 mg\/kg \u2014IV Infusion: 2\u20133 mg\/kg or infusion rate \u20145\u201310 mg\/hour of a solution of 5 mg\/mL

PHARMACOKINETICS <\/H3>
  • Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :274.2 (as hydrochloride)<\/li>\n
  • %Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :
  • 20 to 50 &nbsp &nbsp :<\/li>\n
  • %Excreted unchanged in urine &nbsp &nbsp : 2 (88% as metabolites)<\/li>\n

  • Volume of distribution (L\/kg) &nbsp &nbsp &nbsp :4<\/li>\n

  • half-life \u2013 normal\/ESRD (hrs)&nbsp &nbsp &nbsp :2\u20134\/ Unchanged

    DOSE IN RENAL IMPAIRMENT <\/H3>

    GFR (mL\/MIN)<\/H4>
  • 20 to 50 &nbsp &nbsp : Dose as in normal renal function
  • 10 to 20 &nbsp &nbsp : Dose as in normal renal function
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : Dose as in normal renal function

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES <\/H3>
  • CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:Unlikely dialysability. Dose as in normal renal function<\/p>\n
  • HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Not Dialysed. Dose as in normal renal function
  • HDF\/high flux &nbsp :Unknown dialysability. Dose as in normal renal function
  • CAV\/VVHD &nbsp &nbsp &nbsp:Not Dialysed. Dose as in normal renal function

    IMPORTANT DRUG INTERACTIONS <\/H3>Potentially hazardous interactions with other drugsAdrenergic-neurone blockers: enhanced hypotensive effectAntihypertensives: enhanced hypotensive effect\n
  • Antidepressants: stop MAOIs 2 weeks before surgery; increased risk of arrhythmias and hypotension with tricyclics\n
  • Antipsychotics: enhanced hypotensive effectMemantine: increased risk of CNS toxicity, avoid concomitant use

    ADMINISTRATION <\/H3>

    Reconstition<\/H4>\u2013

    Route <\/H4>IV bolus, IV Infusion, IM

    Rate of Administration <\/H4>Injection: over at least 60 seconds Infusion: Depends on clinical indication

    Comments<\/H4>For infusion add to glucose 5% or sodium chloride 0.9%, dilute to 1 mg\/mL. In the USA can dilute to 2 mg\/mL in fluid restricted patients (Dollery)Incompatible with diazepam and barbituratesUse infusion solutions within 24 hours 100 mg\/mL strength must be diluted with an equal volume of water for injection, sodium chloride 0.9% or glucose 5% before useMinimum volume 50 mg\/mL (undiluted). (UK Critical Care Group, Minimum Infusion Volumes for fluid restricted critically ill patients, 3rd Edition, 2006)

    OTHER INFORMATION <\/H4>\n
  • Contraindicated in patients with severe hypertension; 1\u20132 mg\/kg can increase arterial systolic blood pressure by approximately 20\u201340 mmHgAvoid in those prone to hallucinations or psychotic disorders4\u201310% can be removed by haemodialysis .
    \n","protected":false},"excerpt":{"rendered":"

    Ketamine CLINICAL USE Anaesthetic agent, analgesic DOSE IN NORMAL RENAL<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[7],"class_list":["post-4098","post","type-post","status-publish","format-standard","hentry","category-blog","tag-post-by-auto-php"],"_links":{"self":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/4098","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/comments?post=4098"}],"version-history":[{"count":0,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/4098\/revisions"}],"wp:attachment":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/media?parent=4098"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/categories?post=4098"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/tags?post=4098"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}