KETAMINE
(Ketalar)Standard Prescription
ketamine__mg IV x 1 dose (__mg/kg/dose)
ketamine__mcg/kg/min continuous IV infusion
ketamine__mcg/kg/min continuous IV infusion
Dosages
Maintenance of Sedation in ICU:
5-20 mcg/kg/min by continuous IV infusion
Procedural Sedation:
0.1-4 mcg/kg/min by continuous IV infusion without concomitant opioid
(usual starting dose for continuous infusion is 1 mcg/kg/min)
5-20 mcg/kg/min by continuous IV infusion
Procedural Sedation:
5-10 mg/kg/dose PO x 1 dose [consider 3mg/kg if used with other agents (eg. midazolam)]
0.5-1 mg/kg/dose IV; two subsequent doses of 0.5 mg/kg may be given as required to a maximum total dose of 2 mg/kg
(do not combine PO and IV dosing)Adjuvant Analgesia (Acute Pain Service to prescribe):
0.25-1 mg/kg IV Q 10 min
0.1-2 mcg/kg/min by continuous IV infusion as an adjunct to opioids0.1-4 mcg/kg/min by continuous IV infusion without concomitant opioid
(usual starting dose for continuous infusion is 1 mcg/kg/min)
Mechanism of Action
General anesthetic; dissociative agent; phencyclidine (PCP) derivative that binds to NMDA receptor
Forms Supplied
injection: 10 mg/mL - 2 mL vial, 50 mg/mL - 2 mL , 10 mL vials
50 mg/mL inj used for oral doses (supplied by pharmacy in oral bottles)
Comments
IV onset is 1 min. PO onset is 15-30 min.
Duration IV is 10-15 min.; duration PO 1 hour or longer.
Relative contraindication with hypertension, thyrotoxicosis, angina and psychotic disorders due to indirect sympathomimetic activity.
Monitor respiration and pulse oximetry as apnea can occur.
Ketamine is now classed as a controlled drug and must be managed as per narcotics.
Administration of IV ketamine for procedural sedation is restricted to critical care and other select areas and is to be administered by physicians trained in its use. Patients are to be monitored according to hospital sedation guidelines and all equipment for resuscitation should be readily available. Refer to Procedural Sedation and Analgesia Standards and Guidelines
Duration IV is 10-15 min.; duration PO 1 hour or longer.
Note concentration of vial prior to use (2 strengths available).
Relative contraindication with hypertension, thyrotoxicosis, angina and psychotic disorders due to indirect sympathomimetic activity.
Monitor respiration and pulse oximetry as apnea can occur.
Ketamine is now classed as a controlled drug and must be managed as per narcotics.
Administration of IV ketamine for procedural sedation is restricted to critical care and other select areas and is to be administered by physicians trained in its use. Patients are to be monitored according to hospital sedation guidelines and all equipment for resuscitation should be readily available. Refer to Procedural Sedation and Analgesia Standards and Guidelines
References
49, 79, 398, 399
Last Edited
2022-07-03 18:55:52