Ketaminum

Кетамин Drug photo

The description is actual on 23.12.2014

  • Latin name: Ketamine
  • ATH code: N01AX03
  • Active ingredient: Ketaminum (Ketamine)
  • Producer: Moscow endocrine plant (Russia)

Structure

1 ml of solution of 5% contains 50 mg of active component of Ketaminum of a hydrochloride.

Release form

Ketaminum is issued in ampoules on 2 and 10 ml. Each pack from a cardboard contains about 10 ampoules.

Pharmacological action

What is Ketaminum? This means which at intramuscular or intravenous injection is capable to render anesthetizing (anesthetizing) and analgeziruyushchy influences. Pharmacological group – "Narcotic means". Active ingredient has short effect, and in narcotic doses allows to keep adequate independent breath. The HP possesses dissociative general anesthesia that is explained by the oppressing influence concerning subcrustal formations of a thalamus and associative zone.

The mechanism of action of Ketaminum is based on selective suppression of neyronalny transfer in structure of a cerebral cortex, both in a thalamus, and in associative zones. In too time stimulation of limbic system and a hippocampus is observed. As a result functional dissociation of nonspecific bonds in structure of a thalamus and mesencephalon develops, the arriving nociceptive afferent incentives in the highest think-tanks from a spinal cord are blocked, pulse transfer to a myelencephalon (a reticular formation) is oppressed. It is considered that the anesthetizing and hypnotic effects of Ketaminum are connected with influence of active agent on various types of receptors. Effects of a medicine are not connected about blocking of natrium channels in a nervous system and impact on GAMK-receptors. Wikipedia contains information on history of synthesizing of Ketaminum.

Pharmacodynamics and pharmacokinetics

Ketaminum this lipophilic connection which is quickly enough capable to be distributed at first in well krovosnabzhayemy bodies, and then and in fabrics with reduced perfusion. It is metabolized in hepatic system. Through kidneys it is removed in the form of the conjugated substances metabolites.

Indications to use

Ketaminum what is it? the Medicine is applied as to a monoanaesthesia (1 component), and to the combined anesthesia mainly at persons with the low level of a blood pressure, or in need of preservation at the patient of independent breath. Most often Ketaminum is applied during evacuation at massive blood losses and traumatic shock, at short-term cardiac operations, in the emergency surgery. Ketaminum is appointed at:

  • heart catheterizations;
  • endoscopic manipulations;
  • bandagings in otorhinolaryngology, ophthalmology and stomatology.

The medicine can be applied at Cesarean section in obstetric practice.

Contraindications

In need of use of muscle relaxants during throat operations Ketaminum is appointed with care. Mixing with solutions of barbiturates because of risk of loss of a deposit is inadmissible.

Side effects

The medicine makes the general impact on a human body. At administration of solution raising of a blood pressure for 20-30%, heartbeat increase, increase of minute volume of blood, decrease in peripheric resistance of vessels is registered. Use of Sibazonum (Diazepam) helps to reduce the stimulating influence of Ketaminum on cordial activity. In most cases active component does not oppress reflexes of an upper part of a respiratory path, does not cause a bronchospasm, a laryngospasm, vomiting and nausea. Respiratory depression is registered at solution injection fast intravenously. Atropine and Methacinum allow to lower a sialosis. At introduction of a medicine hallucinations, a hyper tone, the involuntary movements can be registered (it is stopped at introduction of Droperidolum and tranquilizers). Reddening of integuments on the vein course in the place of an injection is possible; when awakening from an anesthesia – a long disorientation and psychomotor excitement.

Application instruction of Ketaminum (Way and dosage)

Solution is entered intravenously (fractionally / struyno) or intramusculary. Intravenously adult enter 2-3 mg, intramusculary – 4-8 mg on 1 kg of weight. Repeated introduction of Ketaminum allows to prolong an anesthesia (speed of 2 mg/kg/h). Such way of introduction is possible in the presence of infuzomat or is reached by drop administration of solution of Ketaminum of 1% in solution of sodium chloride or isotonic solution (30-60 drops a minute).

In pediatric practice solution is applied to the combined anesthesia. Calculation is made according to the scheme: 4-5 mg/kg in the form of solution of 5%. Obligatory premedication is required.

Medicine can be applied together with analgetics (Promedolum, Fentanyl, a depidolor, etc.) and neuroleptics (for example, Droperidolum), however the dose decline for this purpose is required.

Overdose

Respiratory depression is registered that demands carrying out timely artificial ventilation of the lungs.

Interaction

Ketaminum is incompatible with barbiturates at the chemical level (precipitated calcium superphosphate is formed). The medicine is capable to exponentiate action of all means applied to an inhalation anesthesia. Medicine strengthens effect of tubocurarine, but the pankuroniya does not influence efficiency of a suktsinilkholin also.

Terms of sale

Is on sale only for hospitals and medical institutions, it is not intended for free sale.

Storage conditions

The producer recommends to observe standard temperature condition of 15-25 degrees. To limit the admission of children to solution.

Period of validity

5 years.

Special instructions

At pathology of renal system it is applied with care. At operative measures on a throat and a throat introduction of muscle relaxants is obligatory. During the day after introduction of Ketaminum it is impossible to manage motor transport because of block of reaction and decrease in attention.

Analogs

Coincidence on the ATH code of the 4th level:
Section: Anesthetics
in more detail

Education: Graduated from the Bashkir state medical university majoring in "Medical business". In 2011 gained the diploma and the certificate in Therapy. In 2012 received 2 certificate and the diploma in "Functional diagnosis" and "Cardiology". In 2013 completed courses on "Topical issues of otorhinolaryngology in therapy". In 2014 completed advanced training courses in "A clinical echocardiography" and courses in "Medical rehabilitation".

Experience: From 2011 to 2014 the Policlinic No. 33 Ufa worked as the therapist and the cardiologist in MBUZ. Since 2014 the Policlinic No. 33 Ufa works as the cardiologist and the doctor of functional diagnosis in MBUZ.

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