Ketamine

氯胺酮被用作手术的麻醉剂、抑郁症的治疗药物，并且是一种滥用药物。氯胺酮被美国食品药品监督管理局（FDA）批准作为麻醉剂，用于使您在手术期间短暂入睡，并帮助预防疼痛和不适。氯胺酮用于治疗抑郁症属于超适应症用药，其用于抑郁症的治疗目前正在临床试验中进行研究。它也是一种滥用药物，非法用于娱乐目的，因其致幻性质而被滥用，并且已知是一种“约会强奸”药物，因为它会导致短期记忆丧失。

氯胺酮不是阿片类药物；它是一种NMDA受体拮抗剂，这意味着它可以阻断大脑中的N-甲基-D-天冬氨酸（NMDA）神经递质。

当用于麻醉时，氯胺酮通过静脉注射（IV）或肌肉注射（IM）给药。

Esketamine（商品名Spravato）用于治疗抑郁症；它是外消旋氯胺酮的一种形式，在2019年被FDA批准用于特定类型的抑郁症。Spravato是一种鼻喷雾剂，需要在严格的医疗监督下使用，不能由患者在家自行使用。

氯胺酮被FDA批准作为一种全身麻醉剂，用于不需要骨骼肌松弛的诊断和外科手术程序中的单一麻醉剂。它还用于其他全身麻醉剂给药前诱导麻醉，并作为其他麻醉剂的补充。氯胺酮未被FDA批准用于治疗抑郁症；它在该适应症中是超适应症用药。

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• Citalopram

Emergence reactions Tell your caregivers if you have hallucinations or unusual thoughts while waking up from anesthesia.

Hemodynamic instability Temporary increases in blood pressure, heart rate, and cardiac index may be observed during administration. Vital signs and cardiac function should be monitored during administration.

Risk of respiratory depression may occur with overdosage or too rapid a rate of administration. Maintain adequate oxygenation and ventilation

Risks of using ketamine alone for procedures of the pharynx, larynx, or bronchial tree Pharyngeal and laryngeal reflexes are not suppressed with ketamine when it is used alone. Avoid use as a sole anesthetic agent in surgery or diagnostic procedures of the pharynx, larynx, or bronchial tree. Muscle relaxants may be required.

Pediatric neurotoxicity Studies conducted in young animals and children suggest repeated or prolonged use of general anesthetic or sedation drugs in children younger than 3 years may have negative effects on their developing brains. Discuss with parents and caregivers the benefits, risks, timing, and duration of surgery or procedures requiring anesthetic and sedation drugs.

Drug-induced liver injury is associated with the administration of this medicine.

Increase in cerebrospinal fluid pressure An increase in intracranial pressure has been reported following the administration of this medicine. Patients with elevated intracranial pressure should be in a monitored setting with frequent neurologic assessments.

FDA warning. The FDA released a warning on October 10, 2023, about about potential risks associated with compounded ketamine products, including oral formulations, for the treatment of psychiatric disorders, as they have not been evaluated for safety, effectiveness, or quality prior to marketing. When these products are used at home, there is an additional risk because onsite monitoring by a healthcare provider is not available

氯胺酮的严重副作用

氯胺酮的严重副作用包括：

• 心跳缓慢、呼吸微弱或浅表；或
• 感觉头晕，好像要昏倒了；
• 抽搐样的肌肉运动，看起来像痉挛；
• 排尿疼痛或困难、尿频、尿失禁、尿中带血。

如果你出现上述任何症状，请立即联系你的医生。

如果你在从麻醉中苏醒时出现幻觉或不寻常的想法，请告诉你的护理人员。

过敏反应——如果你出现过敏反应的迹象，如荨麻疹、呼吸困难和面部、嘴唇、舌头或喉咙肿胀，请立即寻求紧急医疗帮助。

氯胺酮的常见副作用

氯胺酮的常见副作用是混乱或类似梦境的感觉。

这并非副作用的完整列表，其他副作用也可能会发生。关于副作用，请向医生咨询医疗建议。你可以向FDA报告副作用，电话是1-800-FDA-1088。

如果你对氯胺酮过敏或者患有未经治疗或未得到控制的高血压（高血压），你不应该使用氯胺酮。

如果你曾经有过以下情况，请告诉你的医生：

• 心脏病；
• 高血压；
• 肝病；
• 酗酒；或
• 如果你大量饮酒。

怀孕和哺乳

如果你怀孕了或者正在哺乳，请告知你的医生。

麻醉可能会影响幼儿或胎儿（在母体内）的大脑发育，导致日后出现学习或行为问题。长时间手术或重复性操作的风险最高。

对于危及生命的状况、医疗紧急情况或矫正先天缺陷的手术，麻醉仍然是必要的。你的医生可以告知你在手术或程序中使用的所有药物。

请咨询医生，在你接受氯胺酮治疗后是否可以安全地进行哺乳。

如果你使用其他使你昏昏欲睡或减缓呼吸的药物，你从麻醉中恢复的时间可能会更长。这包括阿片类药物、安眠药、肌肉松弛剂或治疗焦虑或癫痫的药物。

其他药物可能会影响氯胺酮的效果，包括处方药和非处方药、维生素和草药产品。请告知医生你使用的所有其他药物。

如果你服用茶碱、氨茶碱、拟交感神经药物、加压素、苯二氮卓类药物、阿片类镇痛药或其他中枢神经系统抑制剂，请告知你的医生。

这里并未列出所有可能的相互作用。

Usual Adult Ketamine Dose for Anesthesia:

Intravenous injection (IV)
Induction: 1 to 4.5 mg/kg IV; alternatively, 1 to 2 mg/kg IV at a rate of 0.5 mg/kg/min; (2 mg/kg dose provides 5 to 10 minutes of surgical anesthesia within 30 seconds)
Maintenance: The maintenance dose should be adjusted according to the patient's anesthetic needs and whether an additional anesthetic is employed. Increments of one-half to the full induction dose may be repeated as needed for maintenance of anesthesia.

Intramuscular injection (IM)
Induction: 6.5 to 13 mg/kg IM; (9 to 13 mg/kg IM provides 12 to 25 minutes of surgical anesthesia)
Maintenance: The maintenance dose should be adjusted according to the patient's anesthetic needs and whether an additional anesthetic is employed. Increments of one-half to the full induction dose may be repeated as needed for maintenance of anesthesia.

Comments: This drug should be administered slowly over a period of 60 seconds (more rapid administration may result in respiratory depression and enhanced pressor response).
The larger the total dose, the longer the complete recovery will be.
Because of rapid induction following the initial IV injection, the patient should be in a supported position during administration.

Usual Pediatric Ketamine Dose for Anesthesia:

16 years and older: See adult dosing.

For more detailed dosing information, click on the link below.

氯胺酮作为单剂量使用，没有每日给药计划。

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