Medication 7-494 - Ketamine (Ketalar)

CMH EMS & MIH Protocols

Scope of Practice:

• Registered Nurse
• Paramedic
• Community Paramedic

Route(s):

• IM/SQ, IO, IV,

Pharmacodynamics (class and mechanism of action):

• Dissociative anesthetic (NMDA receptor antagonist. Produces state of anesthesia while maintaining airway reflexes, heart rate, and blood pressure. Acts on cortex and limbic receptors, producing dissociative analgesia and sedation. Higher doses act on the μ (Mu) opiod receptor.).

Pharmacokinetics:

• Half-life: 2.5-3 hours.
• Onset time:
• IM: 1-5 minutes.
• IV: Seconds.
• Peak action time: Unknown.
• Duration of action:
• IM: 0.5-2 hours.
• IV: Unknown.

• Peak	8	16	24	32	40	48	56	64	72	80	minutes
  Duration	8	16	24	32	40	48	56	64	72	80	minutes

Dosing:

• Use IDEAL body weight for analgesic dosing, NOT actual body weight.
• Refer to specific protocol(s) below for dose(s).

Indications:

• Protocol 2-044 - Airway: RSI.
• Protocol 2-110 - Behavioral.
• Protocol 2-660 - Pain Control.

Contraindications:

• Hypersensitivity.

Pregnancy Risk Factor:

• Category C
• Risk not ruled out: Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks. FDA requires a relatively large amount of high-quality data on a pharmaceutical for it to be defined as Pregnancy Category A. As a result of this, many drugs that would be considered Pregnancy Category A in other countries are allocated to Category C by the FDA.

Potential Incompatibilities:

• NA.

Precautions and Adverse Effects:

• Calculate analgesic dose based on IDEAL body weight.
• Slow push to avoid apnea.
• Use caution in patients where significant Hypertension would be hazardous (i.e. Stroke, Head Trauma, ICP, MI).
• May cause glaucoma, hypovolemia, dehydration, cardiac disease, emergence phenomena, Hypertension, Tachycardia, hypotension, Bradycardia, arrhythmias, respiratory depression, apnea, laryngospasms, tonic/clonic movements, and/or Vomiting.

Antidote:

• NA.

Controlled Substance Information:

• Schedule III
• Medium potential for abuse. Abusing the drug can cause severe mental addiction, or moderate physical addiction.
• DEA number: 7285.
• Narcotic: No.
• Street names: Black Hole, Bump, Cat Killer, Cat Valium, Coke, Green, Honey Oil, Jet, K Hole, K, Ket, Kit Kat, Kitty Flipping, Purple, Special K, Special LA, Super Acid, Super C, Vitamin K.

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Polk, Hickory, Cedar, & St Clair County EMS Protocols is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.