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What's the Buzz about Ketamine?


vial of ketamine

Photo courtesy of Pfizer


Ketamine (Ketamine hydrochloride) (Street name "K' or "Special K") is used either alone or in combination for induction of anesthesia. It is also used in the emergency department for short-term sedation, such as when a breathing tube needs to be inserted rapidly or a bone needs to be put back in place (from a fracture or dislocation).

It can be used in children as young as 3 months of age.


It is also used (off-label) for the treatment of severe pain, including trauma, fractures, and abdominal and flank pain. When used for pain, it is given in lower doses alone or in combination with other drugs, such as non-steroidal drugs or opioids. Doctors are also using ketamine to treat patients who are depressed or suicidal successfully, although it has not been FDA-approved for that use.


In higher doses, ketamine causes a dissociative state (where a person disconnects from their thoughts, feelings, memories, or sense of identity). Ketamine is metabolized by the liver, so it must be given with great caution to people with liver disease. It is potentially fatal in someone drunk.


Illicit use of ketamine includes inhalation, snorting, and swallowing in food or drinks.


Drug dependence and tolerance may develop after long-term use. A person can go through withdrawal if it is stopped suddenly.

 

Mental side effects can include hallucinations, flashbacks, unusual thoughts, extreme fear, excitement, irrational behavior, insomnia, physical and psychological dependence, or addiction if it is used for recreation. It is dangerous to use combined with alcohol.

A person taking ketamine should have monitoring of their vital signs and heart function, pulse, breathing, and oxygen saturation. Emergency resuscitation equipment should be near to help the person breathe if necessary.


People taking ketamine should be warned that it should only be taken as prescribed and the person should not exceed that dose. It's essential patients know not to combine ketamine with other medications or substances that can make them sleepy, such as alcohol, sleep medication, anti-anxiety medications, or opiates.


References:

ROSENBAUM, Stephen B, GUPTA,Vikas PATEL,Preeti PALACIOUS, Jorge, Ketamine, National Library of Medicine, https://www.ncbi.nlm.nih.gov/books/NBK470357/


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