Ketamine (Ketalar)

  • Medication used especially for deep sedation in pediatric patients.
  • Not a primary use drug.
  • Administer drug only with previous experience or under the direction of a provider familiar with its use.

Mechanism of Action

Selectively interrupts cerebral pathways, causing dissociative anesthesia.

Dosage and Administration

Route

Onset of Action

Peak Effect

Duration

IV

Immediate

15 to 30 seconds

5 to 10 minutes

  • Usually 0.25 to 1.0 mg/kg. 
  • Dose is based on patient response to medication.
  • Rate of infusion should not exceed 50 mcg/kg/min.

Adverse Reactions

  • Respiratory effects – bradypnea, dyspnea, respiratory depression, apnea, bronchial smooth muscle relaxation, increased tracheo-bronchial tree secretions
  • Cardiovascular effects – bradycardia, tachycardia, hypertension, hypotension, arrhythmias
  • Musculoskeletal – enhanced skeletal tone
  • CNS  – uncontrolled muscle movements, visual illusions
  • GI – vomiting, increased salivary secretions
  • Special considerations – monitor patient for emergent reactions including vivid dreams, or hallucinations. Consider premedication (midazolam) to reduce potential for symptoms.

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