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[Ketamine: clinically useful--pharmacologically interesting].

A Maurset1, I Oye

  • 1Forsvarets Sanitet, Oslo mil/Huseby.

Nordisk Medicin
|January 1, 1990
PubMed
Summary

Ketamine, a dissociative anesthetic, offers pain relief and anesthesia by blocking NMDA receptors. Its distinct enantiomers, R- and S-ketamine, show promise for improved therapeutic applications.

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Area of Science:

  • Anesthesiology
  • Neuropharmacology

Context:

  • Ketamine has been a clinical anesthetic for 25 years.
  • It is a unique dissociative anesthetic with PCP-like properties.
  • Recent interest stems from its efficacy in emergency settings and its mechanism of action.

Purpose:

  • To describe the indications and use of ketamine as an anesthetic.
  • To discuss the various side effects associated with ketamine.
  • To explore the pharmacological mechanisms underlying ketamine's effects.

Summary:

  • Ketamine functions by inhibiting excitatory neurotransmission via NMDA receptors.
  • Analgesic and anesthetic effects are linked to PCP receptor activity at NMDA synapses.
  • Higher doses may involve sigma-receptor mediation, and R- and S-ketamine enantiomers have different profiles.

Impact:

  • Combination with benzodiazepines can mitigate ketamine's side effects.
  • Understanding ketamine's mechanisms may lead to improved anesthetic strategies.
  • Enantiomeric differences offer potential for drug optimization.

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