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Intramuscular Ketamine Pharmacokinetics in Humans: A Review
Julian Ananyev1, Todd M Myers2
1United States Army Medical Research Institute of Chemical Defense, 8350 Ricketts Point Rd., Aberdeen Proving Ground, MD, 21010, USA.
Summary
This review summarizes intramuscular ketamine pharmacokinetics, finding dose-dependent plasma concentrations and rapid absorption. Further data are needed for optimal dosing in diverse clinical scenarios.
Area of Science:
- Pharmacology
- Clinical Pharmacy
Background:
- Ketamine has been used for anesthesia and analgesia for over 50 years.
- Intramuscular ketamine administration is crucial in resource-limited settings like emergencies.
- Emerging clinical applications necessitate a thorough understanding of ketamine's pharmacokinetics.
Purpose of the Study:
- To review and synthesize existing literature on the pharmacokinetics of intramuscular ketamine in humans.
- To consolidate data on intramuscular ketamine absorption, distribution, metabolism, and excretion.
- To identify gaps in knowledge regarding intramuscular ketamine pharmacokinetics.
Main Methods:
- Systematic literature search for studies on intramuscular ketamine pharmacokinetics.
- Inclusion of ten studies covering doses from 0.1 to 6.0 mg/kg.
- Analysis of data from healthy volunteers, clinical patients, adults, and children.
Main Results:
- Intramuscular ketamine pharmacokinetics are dose-dependent, with maximal plasma concentrations increasing linearly with dose.
- Time to maximal plasma concentration ranged from 10 to 30 minutes, largely independent of dose.
- Bioavailability varied (41.1-93.0%), and children showed faster absorption than adults.
Conclusions:
- Intramuscular ketamine exhibits dose-dependent pharmacokinetics and rapid absorption.
- Further pharmacokinetic data, particularly at higher doses, are required for optimizing its use in various clinical settings.
- Understanding ketamine kinetics is vital for its expanding therapeutic roles.
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