Ketalar 10 Mg Ml Injection Summary Of Product Characteristics Smpc Emc

The use of halogenated anaesthetics and barbiturates concomitantly with ketamine can lengthen the elimination half-life of ketamine and delay recovery from anaesthesia. For intravenous infusion, intravenous injection or intramuscular injection. Caesarian section; as an induction agent in the absence of elevated blood pressure. All medicines need to be licenced before they can be used to treat patients. Ketamine is licenced for use as an anaesthetic but has also been used for the treatment of pain for many years.

The median peak rise of blood pressure in clinical studies has ranged from 20 to 25 percent of preanaesthetic values. Depending on the condition of the patient, this elevation of blood pressure may be considered a beneficial effect, or in others, an adverse reaction. The initial dose of Ketalar administered intravenously may range from 1 mg/kg to 4.5mg/kg . The average amount required to produce 5 to 10 minutes of surgical anaesthesia has been 2.0 mg/kg. It is recommended that intravenous administration be accomplished slowly .

The presence of norketamine, a pharmacologically active metabolite, is useful for confirmation of ketamine ingestion. It is biotransformed by CYP3A4 and CYP2B6 isoenzymes into norketamine, which, in turn, is converted by CYP2A6 and CYP2B6 into hydroxynorketamine and dehydronorketamine. Low oral bioavailability of ketamine is due to the first-pass effect and, possibly, ketamine intestinal metabolism by CYP3A4. As a result, norketamine plasma levels are several-fold higher than ketamine following oral administration, and norketamine may play a role in anesthetic and analgesic action of oral ketamine. This also explains why oral ketamine levels are independent of CYP2B6 activity, unlike subcutaneous ketamine levels.

Although the incidence of ketamine dependence is unknown, some people who regularly use ketamine develop ketamine dependence. Additionally, the rapid onset of effects following insufflation may increase potential use as a recreational drug. Ketamine tolerance rapidly develops, even with repeated medical use, prompting the use of higher doses. Some daily users reported withdrawal symptoms, primarily anxiety, shaking, sweating, and palpitations, following the attempts to stop. Cognitive deficits as well as increased dissociation and delusion symptoms were observed in frequent recreational users of ketamine. Elevation of blood pressure begins shortly after the injection of Ketalar, reaches a maximum within a few minutes and usually returns to preanaesthetic values within 15 minutes after injection.

Coadministration of ketamine with drugs that induce CYP3A4 enzyme may require an increase in ketamine dosage to achieve the desired clinical outcome. Ketamine may potentiate the neuromuscular blocking effects of atracurium and tubocurarine including respiratory depression with apnoea. Elimination half-life is approximately 2-3 hours, and excretion renal, mostly as conjugated metabolites. Respiratory depression can result from an overdosage of ketamine hydrochloride.

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