(SOLVED) Be sure to explain any relevant scientific rationale and therapeutic considerations/patient teaching that logically ties into each of the following sub-sections.

Ketamine:

Be sure to explain any relevant scientific rationale and therapeutic considerations/patient teaching that logically ties into each of the following sub-sections. Do not simply create lists.

• Pharmacological class and indication
• Pharmacodynamics and Mechanism of action
• Pharmacokinetics (absorption, distribution, metabolism, and excretion)
• Side effects and adverse effects (Do not simply create lists.)
• Contraindications (Do not simply create lists.)

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Ans:

Ketamine

1) Pharmacological class and indication : Ketamine is a rapid-acting general anesthetic and NMDA receptor antagonist used for induction of anesthesia diagnostic and surgical procedures typically in combination with a muscle relaxant.

IV: 1-4.5 mg/kg slow IV once

Alternatively (off-label): 0.5-2 mg/kg slow IV if adjuvant drugs (eg, midazolam) are used, OR

IM: 6.5-13 mg/kg IM once

2) Pharmacodynamics and Mechanism of action: Ketamine's known mechanism of action involves being an antagonist for the NMDA receptors that are found in nerve cells. These receptors are involved in processing central nervous system input. Ketamine blocks this sensory input. This action is what accounts for most of the effects seen from ketamine.

Ketamine modifies electroencephalogram (EEG) differently from other anesthetic drugs. The most typical EEG aspect is the diminution of alpha rhythm amplitude (even its abolition) without modification of its frequency and the appearance of theta waves, without a measurable relationship with the depth of narcosis.

3) Pharmacokinetics (absorption, distribution, metabolism, and excretion)

Absorption - Rapidly absorb through IM route, nasal and oral.

Distribution - Rapidly distributed into highly perfused tissues.

Metabolism - Presents a mainly hepatic and its major metabolite is norketamine

Excretion - through urine

4) Side effects and adverse effects- Emergence reactions, high blood pressure (hypertension), Increased cardiac output, increased intracranial pressure, fast or slow heart rate, Seizures, Visual hallucinations,Vivid dreams,Double vision.

5) Contraindications -

It is contraindicated in those who have shown prior hypersensitivity to the drug.

It is not recommended for use during obstetrics, pregnancy, or breastfeeding as it is unknown if this medication passes into breast milk.

Care must be used in patients who are intoxicated with ethanol due to additive sedation.