Ketaminum

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**Ketaminum**
Natura chemica


Formula chemica	C ₁₃H ₁₆ClNO
Massa molaris	237.725 g/mol
PubChem	3821
DrugBank	DB01221
Natura pharmacologica
Codex ATC	N01AX03 (WHO)
Tempus semivitae biologicum	2.5h-3h Norketaminum: 12h
Metabolismus	iecore (hepaticus): CYP3A4 minus:CYP2B6, CYP2C9
Metaboliti	Norketaminum Dehydro-Norketaminum Hydroxy-Norketaminum
Excretio	renibus (91%), faecibus (1-3%)
Ad usum therapeuticum
Applicatio	per os, s.c., i.m., i.v., intra nasalem

Ketaminum est chemicum cui sunt effectus anaesthetici et analgetici.^[1] Antagonista non competitivus receptoriorum NMDA selectivus in anaesthesiologia ketaminum ad anaesthesiam incipiendam velut tenendam usitatum est^[2], nimirum quoniam corpus in statum somni brevis et interiungendi cum primis memoriae perditu et dolore vacante (indolentia) et sedatione adducit^[3]. Nuper ketaminum in depressionibus tractandis ad beneficentiam conferri expositum est.^[4]

Ketaminum ordinis mundi sanitarii indicem exemplarem medicamentorum essentialium receptum est.

Natura Ketamini

Natura chemica

Ketaminum est cyclohexanoni derivatum, cuius structura chemica (RS)-(±)-2-(2-chlorphenylo)-2-(methylamino)cyclohexan-1-onum et massa molaris 237.725 grammata est. Codex ATC est N01AX03 (WHO).

Natura pharmacologica

Ketaminum est substantia chemica, cuius natura est anaesthetica et analgetica.

Pharmacodynamica

Ketaminum est antagonista non competitivus receptoriorum NMDA selectivus.

Pharmacocinetica

Tempus semivitae biologicum $t_{\frac {1}{2}}$ .^[5] 2½ - 3 h est, quamquam effectus anaestheticus aliquanto brevior quam una hora est.

Excretio

Excretio fit per urinas (>95%).

Effectus Ketamini

Reactiones adversae

Conferatur pagina principalis: Adversa drogae reactio.

Hypersalivatio
Pseudohalucinationes
Nausea, vomitus

Interactiones

Ketaminum interagere potest cum:

benzodiazepinis, quo Diazepamo Ketamini tempus semivitae augeat, ut effectus Ketamini lontiores sint,
hypnoticis, antipsychoticis, barbituratis, opiatis,
hormontis glandulae thyreoideae
sympathomimeticis, Vasopressino,
inductoribus CYP3A4, ut Carbamazepino, Oxcarbazepino, Phenobarbitalo, Phenytoino, Rifampicino, Hyperico perforato,
Theophyllino, Aminophyllino,
suco mali paradisi.

Usus Ketamini

Usus medicus

Ketaminum in medicina ad curam diversorum morborum perturbationumque adhiberi potest:

Anaesthesia
Dolor (analgesia)

Depressio

Depressionis quoque tractationi ketaminum in dosibus subanaestheticis adhiberi potest^[6]. Fieri potest, ut effectus in neuronibus habenularum perficiantur^[7]. Saepe dosis 0.5 mg/kg eligitur, at nonnullibus hominibus doses minores usque ad 0.1 mg/kg satis sunt, in aliis autem doses maiores usque ad 0.75 mg/kg poscantur. Ketamini per venam applicati dodrans necesse est.

Abusus

Usus Ketamini cum periculo abusus coniunctus est^[8]. Praeterea abusus Ketamini non raro cum infectionibus vel damnis tractus urogenitalis inferioris convenire videtur^[9].

Nexus interni

Dependentia

Notae

↑ Sigma-Aldrich de Ketamino.
↑ Drugs.com: de usu ketamini.
↑ Green SM, Roback MG, Kennedy RM, Kraiss B (mai 2011). "Clinical Practice Guideline for Emergency Department Ketamine Dissociative Sedation: 2011 Update". Ann Emergency Med 57 (5): 449-61 .
↑ Zarate CA Jr., Niciu MJ (oct 2015). "Ketamine for Depression: evidence, challenges and promise". World Psych 14 (3): 348-50 .
↑ IUPAC Goldbook.
↑ Andrade C (2017). "Ketamine for Depression, 4: In What Dose, at What Rate, by What Route, for How Long, and at What Frequency?". J Clin Psychiatry 78 (7): e852-7
↑ Yang Y, Cui Y, Sang K, Dong Y, Ni Z, Ma S, Hu H (2018). "Ketamine blocks bursting in the lateral habenula to rapidly relieve depression". Nature 554 (7692): 317-22
↑ Hong YL, Yee CH, Tam YH, Wong JH, Lai PT, Ng CF (2018). "Management of complications of ketamine abuse: 10 years' experience in Hong Kong". Hong Kong Med J 24 (2): 175-81
↑ Chu PS, Ma WK, Wong SC, Chu RW, Cheng CH, Wong S, Tse JM, Lau FL, Yiu MK, Man CW (2008). "The destruction of the lower urinary tract by ketamine abuse: a new syndrome?". BJU Int 102 (11): 1616-22

Nexus externi

DEA (Drug Enforcement Administration) - Magistratus vigilantiae drogarum (CFA): Descriptio ketamini drogae

[1] Sigma-Aldrich de Ketamino.

[2] Drugs.com: de usu ketamini.

[3] Green SM, Roback MG, Kennedy RM, Kraiss B (mai 2011). "Clinical Practice Guideline for Emergency Department Ketamine Dissociative Sedation: 2011 Update". Ann Emergency Med 57 (5): 449-61 .

[ZAR_2015-4] Zarate CA Jr., Niciu MJ (oct 2015). "Ketamine for Depression: evidence, challenges and promise". World Psych 14 (3): 348-50 .

[5] IUPAC Goldbook.

[6] Andrade C (2017). "Ketamine for Depression, 4: In What Dose, at What Rate, by What Route, for How Long, and at What Frequency?". J Clin Psychiatry 78 (7): e852-7

[7] Yang Y, Cui Y, Sang K, Dong Y, Ni Z, Ma S, Hu H (2018). "Ketamine blocks bursting in the lateral habenula to rapidly relieve depression". Nature 554 (7692): 317-22

[8] Hong YL, Yee CH, Tam YH, Wong JH, Lai PT, Ng CF (2018). "Management of complications of ketamine abuse: 10 years' experience in Hong Kong". Hong Kong Med J 24 (2): 175-81

[9] Chu PS, Ma WK, Wong SC, Chu RW, Cheng CH, Wong S, Tse JM, Lau FL, Yiu MK, Man CW (2008). "The destruction of the lower urinary tract by ketamine abuse: a new syndrome?". BJU Int 102 (11): 1616-22

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