| [image] Ketamine | |
| IUPAC name: 2-(2-chlorophenyl)- 2-(methylamino)-cyclohexanone | |
| CAS number 6740-88-1 | ATC code N01AX03 |
| Chemical formula | C13H16ClNO |
| Molecular weight | 237.7 |
| Bioavailability | ? |
| Metabolism | liver |
| Elimination half life | 2.5 hours |
| Excretion | renal (>90%), urine |
| Pregnancy category | ? |
| Legal status | DEA Schedule III (USA) |
| Delivery | Insufflated, Injected, Taken Orally |
Ketamine is a general dissociative anaesthetic for human and veterinary use. Its Hydrochloride salt is sold as KetanestŪ, KetasetŪ, and KetalarŪ. Pharmacologically it is very similar to other dissociative anesthetics such as Tiletamine and phencyclidine (PCP).
Ketamine's "unpleasant" side effects prompted its first Psychedelic use in 1965. The drug was used in psychiatric and other academic research through the 1970s, culminating in 1978 with the publishing of John Lilly's The Scientist, a book documenting the author's ketamine, LSD, and Isolation tank experiments. The incidence of recreational ketamine use increased through the end of the century, especially in the context of raves and other parties. The increase in illicit use prompted ketamine's placement in Schedule III of the United States Controlled Substance Act in August 1999.
Indicated for:
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| Contraindications: |
| Side effects: Severe: Impairs all senses, especially: Cardiovascular:
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Given that it suppresses breathing much less so than most other available anaesthetics, ketamine is still used in human medicine as a first-choice anaesthetic for victims with unknown medical history (e.g. from traffic accidents), in Podiatry and other minor Surgery, and occasionally for the treatment of Migraine. There is ongoing research into the drug's usefulness in pain therapy and for the treatment of Alcoholism and Heroin Addiction.
[image] In Veterinary medicine, ketamine is often used for its anaesthetic and Analgesic effects on cats, Dogs, rabbits, rats, and other small animals. Veterinarians often use ketamine with sedative drugs to produce balanced anaesthesia and analgesia, and as a constant rate infusion to help prevent pain wind-up. Ketamine is used to manage pain among horses and other large animals, though it has less effect on bovines.
Ketamine may be used in small doses (0.1-0.5 mg/kg/hr) as an analgesic, particularly for the treatment of pain associated with movement and neuropathic pain. It has the added benefit of counter-acting spinal sensitization or Wind-up phenomena experienced with chronic pain. At these doses, the psychotropic side effects are less apparent and well managed with benzodiazepines. Ketamine is a co-analgesic, requiring a concomitant low-dose Opioid to be effective.
The effect of Ketamine as a depressant on the respiratory and circulatory systems is less than that of other anaesthetics. When used at anaesthetic doses, it will sometimes stimulate rather than depress the circulatory system. It is sometimes possible to perform ketamine anaesthesia without protective measures to the airways. Ketamine is also a potent Analgesic and can be used in sub-anaesthetic doses to relieve acute pain; however, its psychotropic properties must be taken into account. Patients have reported going into other worlds or seeing God while anaesthetized, and these unwanted psychological side-effects have marginalized the use ketamine in human medicine.
Psychopharmacologically it is a non-competitive glutamate Inhibitor at the NMDA receptors. These occur mainly in the hippocampal formation and in the Prefrontal cortex, which explains ketamine's profound effects on Memory and Thought.
Ketamine produces effects similar to PCP and DXM. Like other dissociative anesthetics in low- to upper-middle dosages, its hallucinogenic effects are only seen against a background lacking sensory stimulation, such as darkness. Users tout its trip as better than that of PCP or LSD because its overt hallucinatory effects are short-acting, lasting an hour or less in most cases. Effects on the senses, judgment, and coordination, however, can last for 18 to 24 hours.
[image] Ketamine's dual anaesthetic/hallucinogenic nature comes from it being a chiral compound, with its two enantiomers having different effects. (S)-ketamine produces anesthetic effects while its enantiomer (R)-ketamine produces hallucinogenic effects.
Ketamine sold illicitly comes from diverted legitimate supplies, primarily veterinary clinics, in either powdered or liquid form. In powdered form its appearance is similar to that of pharmaceutical grade Cocaine and can be insufflated (snorted, also known as "taking bumps") or placed in beverages. Oral use usually requires more material, but results in a longer trip. The liquid can be heated to drive off the solvent (usually saline), leaving powder, or it can be injected. In therapeutic and psychedelic use, the liquid is typically injected intramuscularly. Intravenous injection is uncommon, though possible. It is essentially identical in effect to intramuscular injection, but leads to a much quicker onset - usually within 10 to 15 seconds of dosing - making intravenous self-injection somewhat dangerous.
Like the other dissociative anaesthetics DXM and PCP, hallucinations caused by ketamine are fundamentally different than those caused by tryptamines and phenethylamines. At low doses a user must be in a dark room or have one's eyes closed in order to see any hallucinations, while at medium to high doses the effects are far more intense and obvious, including changes in the perception of distances and durations as well as the visual system being slow to update what the user is seeing. There are reports of high-dosage users being able to see their surroundings in two sharp images, as if the brain is unable to merge the images each eye is sending.
Ketamine puts the user in a dissociated state, meaning that they are less connected to both a sense of self and the reality around them. If a large enough amount is taken the user may go into or through a "K-hole", a state of wildly dissociated experience in which other worlds or dimensions that are difficult to describe with language are said to be perceived, all the while being completely unaware of one's individual identity or the outside world. A user may feel as though his or her perception is located so deep inside the mind that the real world seems distant (hence the use of a "hole" to describe the experience). Some users may not remember this part of the experience after regaining consciousness, in the same way that a person may forget a dream. The "re-integration" process is slow, and the user gradually becomes aware of things around them. At first they may not remember their own name, or even know that they are human, or what that means. Movement is extremely difficult, and users may not be aware that they have a body at all. It may be possible to use this state therapeutically, taking advantage of the dissociation and removing associations from the user's brain. After the experience is over, some of these changes may remain.
Some drug users' first contact with ketamine is accidental, often from a pill sold as something else (commonly ecstasy). Ketamine is also commonly combined with other drugs to enhance their effects.
| Dissociative hallucinogens |
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| {DXM} {Ketamine} {Nitrous oxide} {PCP} {Salvinorin A} |
| Analgesics | ||
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| {Paracetamol (acetaminophen)} {NSAIDs} {Opiates} {Tetrahydrocannabinol} {Ketamine} | ||
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