Find information on thousands of medical conditions and prescription drugs.

Ketamine

Ketamine is a general dissociative anaesthetic for human and veterinary use. Its hydrochloride salt is sold as Ketanest®, Ketaset®, and Ketalar®. Pharmacologically it is very similar to other dissociative anesthetics such as tiletamine and phencyclidine (PCP). more...

Home

Diseases

Medicines

Clonazepam

K-Dur

Kadian

Kainic acid

Kanamycin

Kantrex

Kariva

Kayexalate

Keflex

Kefzol

Kemstro

Keppra

Ketalar

Ketek

Kionex

Klotrix

Konazol

Korostatin

Kytril

History

Ketamine was first synthesized in 1962 in an attempt to find a safer anaesthetic alternative to PCP, which was more likely to cause hallucinations and seizures. The drug was first used on American soldiers during the Vietnam War, but is often avoided now because it can cause unpleasant out-of-body experiences. It is still used widely in veterinary medicine, and for select human applications.

Ketamine's "unpleasant" side effects prompted its first psychedelic use in 1965. The drug was used in psychiatric and other academic research through the 1970s, culminating in 1978 with the publishing of John Lilly's The Scientist, a book documenting the author's ketamine, LSD, and isolation tank experiments. The incidence of recreational ketamine use increased through the end of the century, especially in the context of raves and other parties. The increase in illicit use prompted ketamine's placement in Schedule III of the United States Controlled Substance Act in August 1999. In the United Kingdom, it became outlawed and labelled a Class C drug on January 1, 2006.

Medical use

Given that it suppresses breathing much less so than most other available anaesthetics, ketamine is still used in human medicine as a first-choice anaesthetic for victims with unknown medical history (e.g. from traffic accidents), in podiatry and other minor surgery, and occasionally for the treatment of migraine. There is ongoing research into the drug's usefulness in pain therapy and for the treatment of alcoholism and heroin addiction.

In veterinary medicine, ketamine is often used for its anaesthetic and analgesic effects on cats, dogs, rabbits, rats, and other small animals. Veterinarians often use ketamine with sedative drugs to produce balanced anaesthesia and analgesia, and as a constant rate infusion to help prevent pain wind-up. Ketamine is used to manage pain among horses and other large animals, though it has less effect on bovines.

Ketamine may be used in small doses (0.1–0.5 mg/kg/hr) as an analgesic, particularly for the treatment of pain associated with movement and neuropathic pain. It has the added benefit of counter-acting spinal sensitization or wind-up phenomena experienced with chronic pain. At these doses, the psychotropic side effects are less apparent and well managed with benzodiazepines. Ketamine is a co-analgesic, requiring a concomitant low-dose opioid to be effective.

The effect of Ketamine as a depressant on the respiratory and circulatory systems is less than that of other anaesthetics. When used at anaesthetic doses, it will sometimes stimulate rather than depress the circulatory system. It is sometimes possible to perform ketamine anaesthesia without protective measures to the airways. Ketamine is also a potent analgesic and can be used in sub-anaesthetic doses to relieve acute pain; however, its psychotropic properties must be taken into account. Patients have reported going into other worlds or seeing God while anaesthetized, and these unwanted psychological side-effects have marginalized the use of ketamine in human medicine.

Read more at Wikipedia.org

• [List your site here Free!]

Ketamine Hydrochloride and Fentanyl Citrate Injection
From International Journal of Pharmaceutical Compounding, 11/1/04

METHOD OF PREPARATION

Note: This preparation should he done in a laminar airflow hood in a cleanroom or via isolation barrier technology by a validated aseptic compounding pharmacist using strict aseptic technique.

1. Calculate the required quantity of each ingredient for the total amount to be prepared.

2. Accurately weigh and/or measure each ingredient.

3. Aseptically, obtain the required quantity of ketamine and fentanyl and mix well in a suitable sterile container.

4. Aseptically, add sufficient 0.9% sodium chloride injection to volume and mix well.

5. Package and label.

PACKAGING

Package in tight, light-resistant containers.1

LABELING

Keep out of reach of children. Use only as directed.

STABILITY

If no sterility testing is done, a beyond-use date of 24 hours at room temperature, 3 days at refrigerated temperature or 45 days at

USE

Ketamine and fentanyl in combination are used in the treatment of moderate-to-severe pain.

QUALITY CONTROL

Quality-control assessment can include weight/volume, physical observation, pH, specific gravity, osmolality, assay, color, clarity, particulate matter, sterility and pyrogenicity.3,4

DISCUSSION

Ketamine hydrochloride injection is available in concentrations equivalent to 10, 50 or 100 mg/mL of ketamine base. The pH of the injection is from 3.5 to 5.5. The injection also contains 0.1 mg/mL of benzethonium chloride, and the 10 mg/mL concentration is rendered isotonic with sodium chloride.

Ketamine hydrochloride (C^sub 13^H^sub 16^ClNO.HCl, MW 274.2) is used as an anesthetic and analgesic. It occurs as a white crystalline powder with a slight characteristic odor. Approximately 1.15 mg is equivalent to 1 mg of ketamine base. It is soluble 1 g in 4 mL of water, 14 mL of alcohol and 60 mL of absolute alcohol. Ketamine hydrochloride injection is a sterile solution of ketamine hydrochloride in water for injection. It contains an amount of ketamine hydrochloride equivalent to not less than 95.0% and not more than 105.0% of the labeled amount of ketamine. The injection has a pH of 3.5-5.5, and it contains not more than 0.4 USP endotoxin units per mg of ketamine hydrochloride. It should be stored at controlled room temperature and protected from light.1,5

Fentanyl citrate (C^sub 22^H^sub 28^N^sub 2^O.C^sub 6^H^sub 8^O^sub 7^, MW 528.6) occurs as white granules or as a white crystalline powder. Fentanyl citrate injection contains fentanyl, as the citrate 50 µg per mL with hydrochloric acid and/or sodium hydroxide to adjust pH to the range of 4 to 7.5. Fentanyl citrate 157 µg is approximately equal to 100 µg of fentanyl. It is soluble 1 g in 40 mL of water and slightly soluble in alcohol. The pH of the fentanyl injection is in the range of pH 4.0 to 7.5. Fentanyl citrate is a synthetic opioid analgesic used as a sedative, analgesic, preoperative medication and an adjunct to general or regional anesthesia and in the management of chronic pain.6

0.9% Sodium chloride injection contains not less than 95.0% and not more than 105.0% of the labeled amount of sodium chloride in water for injection. It has a pH between 4.5 and 7.0 and contains no added antimicrobial agents. They can be sterilized by filtration or autoclaving. Sodium chloride will decrease the solubility of some organic compounds; methylparaben is not as soluble in sodium chloride solutions as it is in water. Sodium chloride is soluble in water to the extent of 1 g in 2.8 mL water, and is slightly soluble in alcohol (1 g in 250 mL of 95% ethanol).1

REFERENCES

1. US Pharmacopeial Convention, Inc. United States Pharmacopeia 27-National Formulary 22. Rockville, MD: US Pharmacopeial Convention, Inc.; 2004: 1054-1056, 1700, 2345-2349, 2768.

2. Ambados F, Brealey J. Compatibility of ketamine hydrochloride and fentanyl citrate in polypropylene syringes. Am J Health Syst Pharm 2004; 61: 1438-1439.

3. Allen LV Jr. Standard operating procedure for particulate testing for sterile products. IJPC 1998; 2: 78.

4. Allen LV Jr. Standard operating procedure: Quality assessment for injectable solutions. IJPC 1999; 3: 406-407.

5. Sweetman SC, ed. MARTINDALE: The Complete Drug Reference. 33rd ed. London: Pharmaceutical Press; 2002: 1262-1263.

6. Reynolds JEF, ed. MARTINDALE: The Extra Pharmacopoeia. 30th ed. London: Pharmaceutical Press; 1993: 1076-1077.

Return to Ketamine

Home

Contact

Resources

Exchange Links

ebay