释义 |
Ketalar ThesaurusNoun | 1. | Ketalar - a general anesthetic and tranquilizer (not a barbiturate) that is administered intravenously or intramuscularly; used mainly by veterinarians or for minor surgery with geriatric or pediatric patients; taken in large doses it causes hallucinations similar to those associated with the use of PCPketamine, ketamine hydrochlorideclub drug - a controlled substance that is usually taken by young people at dance clubs and ravesgeneral anaesthetic, general anesthetic - an anesthetic that anesthetizes the entire body and causes loss of consciousnesscat valium, honey oil, special K, super acid, super C, jet, K, green - street names for ketamine |
Ketalar
ketamine (ket-a-meen) ketamine, Ketalar (trade name) Classification Therapeutic: general anesthetics Pregnancy Category: UK
IndicationsAnesthesia for short-term diagnostic and surgical procedures.As induction before the use of other anesthetics.As a supplement to other anesthetics.Provides sedation and analgesia.ActionBlocks afferent impulses of pain perception.Suppresses spinal cord activity.Affects CNS transmitter systems.Therapeutic effectsAnesthesia with profound analgesia, minimal respiratory depression, and minimal skeletal muscle relaxation.PharmacokineticsAbsorption: Rapidly absorbed after IM administration.Distribution: Rapidly distributed. Enters the CNS; crosses the placenta.Metabolism and Excretion: Mostly metabolized by the liver. Some conversion to another active compound.Half-life: 2.5 hr.Time/action profile (anesthesia)ROUTE | ONSET | PEAK | DURATION | IV | 30 sec | unknown | 5–10 min | IM | 3–4 min | unknown | 12–25 min |
Contraindications/PrecautionsContraindicated in: Hypersensitivity; Psychiatric disturbances; Hypertension; ↑ intracranial pressure; Obstetric / Lactation: Pregnancy or lactation.Use Cautiously in: Cardiovascular disease; Procedures involving larynx, pharynx, or bronchial tree (muscle relaxants required); Gastroesophageal reflux; Hepatic dysfunction; History of alcohol abuse; Cerebral trauma; Intracerebral mass or hemorrhage; Hyperthyroidism; History of psychiatric problems; ↑ intraocular pressure; Severe eye trauma.Adverse Reactions/Side EffectsCentral nervous system- emergence reactions (most frequent)
- ↑ intracranial pressure
Ear, Eye, Nose, Throat- diplopia
- ↑ intraocular pressure
- nystagmus
Respiratory- laryngospasm
- respiratory depression and apnea (rapid IV administration of large doses)
Cardiovascular- hypertension (most frequent)
- tachycardia (most frequent)
- arrhythmias
- bradycardia
- hypotension
Gastrointestinal- excessive salivation
- nausea
- vomiting
GenitourinaryDermatologicLocalMusculoskeletalInteractionsDrug-Drug interactionUse with barbiturates, hydroxyzine and opioid analgesics may result in prolonged recovery time.Use with halothane may result in ↓ BP, cardiac output, and heart rate.Use with tubocurarine or nondepolarizing neuromuscular blocking agents may result in prolonged respiratory depression.Concurrent use with thyroidhormone ↑ risk of tachycardia and hypertension.Concurrent administration with diazepam may ↓ incidence of emergence reaction.Concurrent administration with atropine may ↑ incidence of unpleasant dreams.Route/DosageGeneral AnesthesiaIntravenous (Adults) Induction—1–2 mg/kg (range 1–4.5 mg/kg)–2 mg produces 5–10 min of surgical anesthesia or 1–2 mg/kg as a single injection or infused at 0.5 mg/min. May be used with concurrent diazepam. Maintenance—Increments of ½ to the full induction dose may be repeated as needed. If given with concurrent diazepam, an infusion of 0.1–0.5 mg/min may be used, augmented by 2–5 mg doses of diazepam.Intravenous (Children) 0.5–2 mg/kg, use smaller doses (0.5–1 mg/kg)for minor procedures.Intramuscular (Adults) 3–8 mg/kg (10 mg/kg produces 12–25 min of surgical anesthesia).Intramuscular (Children) 3–7 mg/kg.Oral (Children) 6–10 mg/kg for 1 dose (mix in cola or other beverage) 30 min prior to procedure.Sedation/Analgesia (Unlabeled)Intravenous (Adults) 200–750 mcg (0.2–0.75 mg)/kg over 2–3 min initially, followed by 5–20 mcg (0.005–0.02 mg)/kg/min as an infusion.Intravenous (Children) 5–20 mcg/kg/min.Intramuscular (Adults) 2–4 mg/kg initially, then 5–20 mcg (0.005–0.02 mg)/kg/min as an IV infusion.Availability (generic available)Injection: 10 mg/mL, 50 mg/mL, 100 mg/mL Nursing implicationsNursing assessment- Assess level of consciousness frequently throughout therapy. Ketamine produces a dissociative state. The patient does not appear to be asleep and experiences a feeling of dissociation from the environment.
- Monitor BP, ECG, and respiratory status frequently throughout therapy. May cause hypertension and tachycardia. May cause increased CSF pressure and increased intraocular pressure.
Respiratory depression or apnea may be treated with mechanical ventilation or analeptics.
Potential Nursing DiagnosesRisk for injury (Side Effects) Disturbed sensory perception (Adverse Reactions)
Implementation- Do not confuse Ketalar (ketamine) with ketorolac.
- Administer on an empty stomach to prevent vomiting and aspiration.
- May be administered concurrently with a drying agent (atropine, scopolamine); ketamine increases salivary and tracheobronchial mucous gland secretions. Atropine may also increase the incidence of unpleasant dreams.
- Patients may experience a state of confusion (emergence delirium) during recovery from ketamine. Administering a benzodiazepine and minimizing verbal, tactile, and visual stimulation may prevent emergence delirium. Severe emergence delirium may be treated with short- or ultra-short-acting barbiturates.
- Oral: Use 100 mg/mL IV solution and mix appropriate dose in 0.2–0.3 mL/kg of cola or other beverage.
Intravenous Administration- Diluent: Dilute 100 mg/mL concentration with equal parts of sterile water for injection, 0.9% NaCl, or D5W. Concentration: Maximum concentration for slow IV push 50 mg/mL.
- Rate: Administer over 60 sec unless a rapid-sequence induction technique is indicated. More rapid administration may cause respiratory depression, apnea, and hypertension. Do not exceed 0.5 mg/kg/min.
- Continuous Infusion: Diluent: Dilute 10 mL of 50 mg/mL concentration or 5 mL of 100 mg/mL concentration with 500 mL of 0.9% NaCl or D5W and mix well. Concentration: 1 mg/mL. Dilution with 250 mL may be used if fluid restriction is needed, for a maximum concentration of 2 mg/mL.
- Rate: Administer at a rate of 0.5 mg/kg/min for induction. Maintenance infusion may be administered at a rate of 1–2 mg/min or 0.1–0.5 mg/min given concurrently with diazepam. Dose must be titrated according to individual patient requirements. Tonic-clonic movements during anesthesia do not indicate the need for more ketamine.
- Y-Site Compatibility: albumin, amikacin, amiodarone, atropine, caffeine citrate, calcium gluconate, cefazolin, cefepime, cefotaxime, ceftazidime, cefuroxime, chlorpromazine, clindamycin, clonidine, digoxin, diphenhydramine, dobutamine, dopamine, epinephrine, gentamicin, haloperidol, hydrocortisone, magnesium sulfate, meperidine, metoclopramide, metronidazole, midazolam, milrinone, morphine, multivitamins, naloxone, oxytocin, pancuronium, penicillin G, piperacillin/tazobactam, potassium chloride, promethazine, propofol, ranitidine, sufentanil, tobramycin, vancomicin
- Y-Site Incompatibility: acyclovir, ampicillin, furosemide, heparin, insulin, meropenem, phenytoin, potassium phosphates, sodium bicarbonate, trimethoprim/sulfamethoxazole
Patient/Family Teaching- Psychomotor impairment may last for 24 hr after anesthesia. Caution patient to avoid driving or other activities requiring alertness until response to medication is known.
- Advise patient to avoid alcohol or other CNS depressants for 24 hr after anesthesia.
Evaluation/Desired Outcomes- Sense of dissociation and general anesthesia without muscle relaxation.
Ketalar Ketamine, see there. Ketalar A brand name for KETAMINE.Ketalar Related to Ketalar: AmidateSynonyms for Ketalarnoun a general anesthetic and tranquilizer (not a barbiturate) that is administered intravenously or intramuscularlySynonyms- ketamine
- ketamine hydrochloride
Related Words- club drug
- general anaesthetic
- general anesthetic
- cat valium
- honey oil
- special K
- super acid
- super C
- jet
- K
- green
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