كيتامين

الكيتامين (ketamine) مخدّر تفارقي يعمل مضادّاً غير تنافسي لمستقبلات الغلوتامات من نوع N-methyl D-aspartate (NMDA)، ويصف ملخص خصائص المستحضر (SPC) المنشور لدى مديرية الأدوية البيطرية في المملكة المتحدة (VMD) أثره بأنه تخدير تفارقي.

ما هو الدواء وإلى أي صنف ينتمي

يذكر دليل MSD البيطري أن الكيتامين يضادّ مستقبلات NMDA بصورة غير تنافسية وغير نوعية، وأن هذا التضاد هو ما يمنحه أثره المسكّن. تذكر دراسة عن الصورة الجزيئية للكيتامين منشورة في PubMed Central أن للكيتامين ألفةً لمستقبلات وناقلات أخرى، منها مستقبلات الدوبامين D2 والمستقبلات الأفيونية وناقلات الأمينات الأحادية.

آلية العمل

يوضح دليل MSD البيطري أن الغلوتامات والغليسين يفعّلان مستقبلات NMDA أثناء الإحساس المستمر بالألم في القرن الظهري للنخاع الشوكي، وهي المستقبلات التي يضادّها الكيتامين. يذكر دليل MSD البيطري أن تثبيط مستقبلات NMDA يمنع الحساسية المركزية والاستقطاب التراكمي (wind-up) أو يخفّفهما في حيوانات المختبر والبشر. يضيف دليل MSD البيطري أن الكيتامين يتفاعل أيضاً مع المستقبلات الأفيونية من نوع ميو، والمسكارينية، والأحادية الأمين، ومستقبلات حمض غاما-أمينوبيوتيريك (GABA). يذكر ملخص خصائص المستحضر (SPC) أن للكيتامين عند التخدير به تأثيراً سمبثاوياً موسّعاً للقصبات، وأنه يرفع معدل القلب وضغط الدم، ويزيد الدورة الدموية الدماغية والضغط داخل العين. يوضح ملخص خصائص المستحضر (SPC) أن الكيتامين يخضع لتحوّل حيوي كبدي واسع في الكلاب والخيول والرئيسيات، أما في القطط فيحدث بعض الاستقلاب الكبدي لكن معظمه يُطرح عادةً عبر الكلية. يذكر ملخص خصائص المستحضر (SPC) أن الإفاقة من الكيتامين بعد الحقن الوريدي السريع تتم بإعادة توزيعه السريعة من الجهاز العصبي المركزي إلى أنسجة أخرى، أهمها الدهون والرئة والكبد والكلية.

الاستعمالات البيطرية

يذكر ملخص خصائص المستحضر (SPC) أن الكيتامين لا يصلح مخدّراً وحيداً في الكلاب لأنه يزيد التوتر العضلي ويسبب انقباضات عضلية غير منسّقة. يذكر ملخص خصائص المستحضر (SPC) أن الكيتامين يمكن أن يُجمع مع منبّهات مستقبلات ألفا-2 والمخدّرات ومضادات الذهان المسكّنة والمهدّئات والمخدّرات الاستنشاقية لتحسين التخدير أو إطالة أثره. يذكر دليل MSD البيطري أن الكيتامين عُرف منذ زمن طويل بتسكينه الجسدي مقابل تسكين حشوي ضعيف نسبياً. يشير دليل MSD البيطري إلى أن الاهتمام بالكيتامين مسكّناً ازداد بسبب دوره في منع حساسية المسارات المركزية للألم.

السلامة

يذكر ملخص خصائص المستحضر (SPC) أن مضادات الذهان المسكّنة والمهدّئات ونظائر المورفين والسايميتيدين والكلورامفينيكول تعزّز تخدير الكيتامين. يذكر دليل MSD البيطري أن الكيتامين قد يكون سامّاً للأعصاب إذا أُعطي عبر الطريق فوق الجافية أو داخل القراب.

الوضع التنظيمي

خلص مركز الطب البيطري في إدارة الغذاء والدواء الأمريكية (FDA CVM) في ملخص حرية المعلومات إلى أن مستحضر كيتامين هيدروكلوريد للحقن مأمون وفعّال لدواعيه الموسومة ضمن شروط الاستعمال المقترحة، وأن الطلب استوفى متطلبات المادة 512 من القانون. يذكر ملخص حرية المعلومات لدى FDA CVM أن سلامة المستحضر الجنيس وفعاليته اعتُمدتا على التكافؤ الكيميائي مع المستحضر الأصلي بدلاً من اختبار التكافؤ الحيوي. يصنّف ملخص خصائص المستحضر (SPC) المنشور لدى VMD مستحضر كيتامين للحقن دواءً بيطرياً يُصرف بوصفة.

The text below is quoted verbatim from approved veterinary drug labels published by the US FDA (Animal Drugs @ FDA) and DailyMed.

Indications (8)

Primates (2)
  • Subhuman primates

    It is used for restraint or as the sole anesthetic agent in diagnostic or minor, brief surgical procedures that do not require skeletal muscle relaxation.

    Federal law restricts this drug to use by or on the order of a licensed veterinarian.

    Ketaset®

  • Subhuman primates

    It is used for restraint.

    Federal law restricts this drug to use by or on the order of a licensed veterinarian.

    Ketamine HCL

Cats (2)
  • It is used for restraint or as the sole anesthetic agent in diagnostic or minor, brief surgical procedures that do not require skeletal muscle relaxation.

    Federal law restricts this drug to use by or on the order of a licensed veterinarian.

    Ketamine HCL

  • It is used in cats as the sole anesthetic agent for ovariohysterectomy and general surgery.

    Federal law restricts this drug to use by or on the order of a licensed veterinarian. Store in a cool place. Protect from light. Do not use if precipitate appears.

    Ketaset® Plus

Species not stated (4)
  • Indications: Ketamine Hydrochloride Injection may be used in cats for restraint or as the sole anesthetic agent for diagnostic or minor, brief, surgical procedures that do not require skeletal muscle relaxation. It may be used in subhuman primates for restraint.

    Ketamine CIII Hydrochloride Injection

  • ZETAMINE™ may be used in cats for restraint or as the sole anesthetic agent for diagnostic or minor, brief, surgical procedures that do not require skeletal muscle relaxation. It may be used in subhuman primates for restraint.

    Zetamine™ Injection (ketamine hydrochloride injection)

  • KETASET may be used in cats for restraint or as the sole anesthetic agent for diagnostic or minor, brief, surgical procedures that do not require skeletal muscle relaxation. It may be used in subhuman primates for restraint.

    Ketaset® CIII(ketamine hydrochloride injection)

  • Veterinary Injection For Intramuscular Use in Cats and Subhuman Primates Only

    Ketamine CIII Hydrochloride Injection

Contraindications (3)

Species not stated (3)
  • Contraindications: Ketamine Hydrochloride Injection is contraindicated in cats and subhuman primates suffering from renal or hepatic insufficiency. Ketamine Hydrochloride Injection is detoxified by the liver and excreted by the kidneys; therefore, any preexistent hepatic or renal pathology or impairment of function can be expected to result in prolonged anesthesia; related fatalities have been reported.

    Ketamine CIII Hydrochloride Injection

  • ZETAMINE™ is contraindicated in cats and subhuman primates suffering from renal or hepatic insufficiency. ZETAMINE™ is detoxified by the liver and excreted by the kidneys; therefore, any preexistent hepatic or renal pathology or impairment of function can be expected to result in prolonged anesthesia; related fatalities have been reported.

    Zetamine™ Injection (ketamine hydrochloride injection)

  • KETASET is contraindicated in cats and subhuman primates suffering from renal or hepatic insufficiency. KETASET is detoxified by the liver and excreted by the kidneys; therefore, any preexistent hepatic or renal pathology or impairment of function can be expected to result in prolonged anesthesia; related fatalities have been reported.

    Ketaset® CIII(ketamine hydrochloride injection)

Adverse reactions (4)

Species not stated (4)
  • Respiratory depression may occur following administration of high doses of Ketamine Hydrochloride Injection. If at any time respiration becomes excessively depressed and the animal becomes cyanotic, resuscitative measures should be instituted promptly. Adequate pulmonary ventilation using either oxygen or room air is recommended as a resuscitative measure. Adverse reactions reported have included emesis, salivation, vocalization, erratic recovery and prolonged recovery, spastic jerking movements, convulsions, muscular tremors, hypertonicity, opisthotonos, dyspnea and cardiac arrest. In the cat, myoclonic jerking and/or mild tonic convulsions can be controlled by ultrashort-acting barbiturates which should be given to effect. The barbiturates should be administered intravenously at a dose level of one-sixth to one-fourth the usual dose for the product being used. Acepromazine may also be used. However, recent information indicates that some phenothiazine derivatives may potentiate the toxic effects of organic phosphate compounds such as found in flea collars and certain anthelmintics. A study has indicated that ketamine hydrochloride alone does not potentiate the toxic effects of organic phosphate compounds. To report suspected adverse drug experiences, for technical assistance or to obtain a copy of the Safety Data Sheet, contact Covetrus® North America at (855) 724-3461 or covetrus.com. For additional information about adverse drug experience reporting for animal drugs, contact FDA at 1-888-FDA-VETS or online at www.fda.gov/reportanimalae.

    CovetrusKetamine Hydrochloride Injection CIII 100 mg/mL

  • Respiratory depression may occur following administration of high doses of Zetamine™. If at any time respiration becomes excessively depressed and the animal becomes cyanotic, resuscitative measures should be instituted promptly. Adequate pulmonary ventilation using either oxygen or room air is recommended as a resuscitative measure. Adverse reactions reported have included emesis, salivation, vocalization, erratic recovery and prolonged recovery, spastic jerking movements, convulsions, muscular tremors, hypertonicity, opisthotonos, dyspnea and cardiac arrest. In the cat, myoclonic jerking and/or mild tonic convulsions can be controlled by ultrashort-acting barbiturates which should be given to effect. The barbiturates should be administered intravenously at a dose level of one-sixth to one-fourth the usual dose for the product being used. Acepromazine may also be used. However, recent information indicates that some phenothiazine derivatives may potentiate the toxic effects of organic phosphate compounds such as found in flea collars and certain anthelmintics. A study has indicated that ketamine hydrochloride alone does not potentiate the toxic effects of organic phosphate compounds. To report suspected adverse drug experiences, for technical assistance or to obtain a copy of the Safety Data Sheet, contact 1-844-227-6687. For additional information about adverse drug experience reporting for animal drugs, contact FDA at 1-888-FDA-VETS or online at www.fda.gov/reportanimalae.

    VETone® Zetamine™ CIII(ketamine hydrochloride injection)100 mg/mL

  • Respiratory depression may occur following administration of high doses of ZETAMINE™. If at any time respiration becomes excessively depressed and the animal becomes cyanotic, resuscitative measures should be instituted promptly. Adequate pulmonary ventilation using either oxygen or room air is recommended as a resuscitative measure. Adverse reactions reported have included emesis, salivation, vocalization, erratic recovery and prolonged recovery, spastic jerking movements, convulsions, muscular tremors, hypertonicity, opisthotonos, dyspnea and cardiac arrest. In the cat, myoclonic jerking and/or mild tonic convulsions can be controlled by ultrashort-acting barbiturates which should be given to effect. The barbiturates should be administered intravenously at a dose level of one-sixth to one-fourth the usual dose for the product being used. Acepromazine may also be used. However, recent information indicates that some phenothiazine derivatives may potentiate the toxic effects of organic phosphate compounds such as found in flea collars and certain anthelmintics. A study has indicated that ketamine hydrochloride alone does not potentiate the toxic effects of organic phosphate compounds. To report suspected adverse reactions, to obtain a Safety Data Sheet or for technical assistance, call 1-888-637-4251. For additional information about adverse drug experience reporting for animal drugs, contact FDA at 1-888-FDA-VETS, or www.fda.gov/reportanimalae.

    Zetamine™ Injection (ketamine hydrochloride injection)

  • Respiratory depression may occur following administration of high doses of KETASET (ketamine hydrochloride injection, USP). If at any time respiration becomes excessively depressed and the animal becomes cyanotic, resuscitative measures should be instituted promptly. Adequate pulmonary ventilation using either oxygen or room air is recommended as a resuscitative measure. Adverse reactions reported have included emesis, salivation, vocalization, erratic recovery and prolonged recovery, spastic jerking movements, convulsions, muscular tremors, hypertonicity, opisthotonos, dyspnea and cardiac arrest. In the cat, myoclonic jerking and/or mild tonic convulsions can be controlled by ultrashort-acting barbiturates which should be given to effect. The barbiturates should be administered intravenously at a dose level of one-sixth to one-fourth the usual dose for the product being used. Acepromazine may also be used. However, recent information indicates that some phenothiazine derivatives may potentiate the toxic effects of organic phosphate compounds such as found in flea collars and certain anthelmintics. A study has indicated that ketamine hydrochloride alone does not potentiate the toxic effects of organic phosphate compounds. To report suspected adverse reactions, to obtain a Material Safety Data Sheet or for technical assistance, call 1-888-963-8471.

    Ketaset® CIII(ketamine hydrochloride injection)

Dosage (9)

Primates (2)
  • Subhuman primates

    It is administered intramuscularly at a recommended dose that ranges from 3 to 15 milligrams per kilogram of body weight depending upon the species, general condition and age of the subject.

    Intramuscular

    Federal law restricts this drug to use by or on the order of a licensed veterinarian.

    Ketamine HCL

  • Subhuman primates

    It is administered intramuscularly at a recommended dose that ranges from 5 to 15 milligrams per pound of body weight depending on the effect desired.

    Intramuscular

    Federal law restricts this drug to use by or on the order of a licensed veterinarian.

    Ketaset®

Cats (2)
  • It is administered intramuscularly at a recommended dose from 15 to 20 milligrams ketamine base per pound of body weight, depending on the effect desired.

    Intramuscular

    Federal law restricts this drug to use by or on the order of a licensed veterinarian. Store in a cool place. Protect from light. Do not use if precipitate appears.

    Ketaset® Plus

  • It is administered intramuscularly at a recommended dose that ranges from 5 to 15 milligrams per pound of body weight depending on the effect desired.

    Intramuscular

    Federal law restricts this drug to use by or on the order of a licensed veterinarian.

    Ketamine HCL

Species not stated (5)
  • Ketamine Hydrochloride Injection is well tolerated by cats and subhuman primates when administered by intramuscular injection. Fasting prior to induction of anesthesia or restraint with Ketamine Hydrochloride Injection is not essential; however, when preparing for elective surgery, it is advisable to withhold food for at least six hours prior to administration of Ketamine Hydrochloride Injection. Anesthesia may be of shorter duration in immature cats. Restraint in subhuman primate neonates (less than 24 hours of age) is difficult to achieve. As with other anesthetic agents, the individual response to Ketamine Hydrochloride Injection is somewhat varied depending upon the dose, general condition and age of the subject so that dosage recommendations cannot be absolutely fixed. Dosage Cats: A dose of 11 mg/kg (5 mg/lb) is recommended to produce restraint. Dosages from 22 to 33 mg/kg (10 to 15 mg/lb) produce anesthesia that is suitable for diagnostic or minor surgical procedures that do not require skeletal muscle relaxation. Subhuman Primates: The recommended restraint dosages of Ketamine Hydrochloride Injection for the following species are: Cercocebus torquatus (white-collared mangabey), Papio cynocephalus (yellow baboon), Pan troglodytes verus (chimpanzee), Papio anubis (olive baboon), Pongo pygmaeus (orangutan), Macaca nemestrina (pig-tailed macaque) 5 to 7.5 mg/kg; Presbytis entellus (entellus langur) 3 to 5 mg/kg; Gorilla gorilla gorilla (gorilla) 7 to 10 mg/kg; Aotus trivirgatus (night monkey) 10 to 12 mg/kg; Macaca mulatta (rhesus monkey) 5 to 10 mg/kg; Cebus capucinus (white-throated capuchin) 13 to 15 mg/kg; and Macaca fascicularis (crab-eating macaque), Macaca radiata (bonnet macaque) and Saimiri sciureus (squirrel monkey) 12 to 15 mg/kg. A single intramuscular injection produces restraint suitable for TB testing; radiography, physical examination or blood collection.

    INTRAMUSCULAR

    Ketamine Hydrochloride Injection CIII 100 mg/mL

  • The recommended restraint dosages of Ketamine hydrochloride injection for the following species are: Cercocebus torquatus (white-collared mangabey), Papio cynocephalus (yellow baboon), Pan troglodytes verus (chimpanzee), Papio anubis (olive baboon), Pongo pygmaeus (orangutan), Macaca nemestrina (pig-tailed macaque) 5 to 7.5 mg/kg; Presbytis entellus (entellus langur) 3 to 5 mg/kg; Gorilla gorilla gorilla (gorilla) 7 to 10 mg/kg; Aotus trivirgatus (night monkey) 10 to 12 mg/kg; Macaca mulatta (rhesus monkey) 5 to 10 mg/kg; Cebus capucinus (white-throated capuchin) 13 to 15 mg/kg; and Macaca fascicularis (crab-eating macaque), Macaca radiata (bonnet macaque) and Saimiri sciureus (squirrel monkey) 12 to 15 mg/kg. A single intramuscular injection produces restraint suitable for TB testing; radiography, physical examination or blood collection.

    INTRAMUSCULAR

    Ketamine hydrochloride injection

  • Dosage and Administration: Ketamine Hydrochloride Injection is well tolerated by cats and subhuman primates when administered by intramuscular injection. Fasting prior to induction of anesthesia or restraint with Ketamine Hydrochloride Injection is not essential; however, when preparing for elective surgery, it is advisable to withhold food for at least six hours prior to administration of Ketamine Hydrochloride Injection. Anesthesia may be of shorter duration in immature cats. Restraint in subhuman primate neonates (less than 24 hours of age) is difficult to achieve. As with other anesthetic agents, the individual response to Ketamine Hydrochloride Injection is somewhat varied depending upon the dose, general condition and age of the subject so that dosage recommendations cannot be absolutely fixed.

    INTRAMUSCULAR

    Ketamine CIII Hydrochloride Injection

  • ZETAMINE™ is well tolerated by cats and subhuman primates when administered by intramuscular injection. Fasting prior to induction of anesthesia or restraint with ZETAMINE™ is not essential; however, when preparing for elective surgery, it is advisable to withhold food for at least six hours prior to administration of ZETAMINE™. Anesthesia may be of shorter duration in immature cats. Restraint in subhuman primate neonates (less than 24 hours of age) is difficult to achieve. As with other anesthetic agents, the individual response to ZETAMINE™ is somewhat varied depending upon the dose, general condition and age of the subject so that dosage recommendations cannot be absolutely fixed.

    INTRAMUSCULAR

    Zetamine™ Injection (ketamine hydrochloride injection)

  • A dose of 11 mg/kg (5 mg/lb) is recommended to produce restraint. Dosages from 22 to 33 mg/kg (10 to 15 mg/lb) produce anesthesia that is suitable for diagnostic or minor surgical procedures that do not require skeletal muscle relaxation.

    INTRAMUSCULAR

    Zetamine™ Injection (ketamine hydrochloride injection)

Available strengths (16)

ProductDosage formAvailable strengths
Ketamine HCLLiquid (Solution)Each milliliter contains ketamine hydrochloride equivalent to 100 milligrams ketamine base activity.
Ketamine HCLLiquid (Solution)Each milliliter contains ketamine hydrochloride equivalent to 100 milligrams ketamine base activity.
KetaFlo™Liquid (Solution)The drug is a sterile aqueous solution and each milliliter contains: Ketamine hydrochloride equivalent to 100 milligrams ketamine base activity.
KetaFlo™Liquid (Solution)The drug is a sterile aqueous solution and each milliliter contains: Ketamine hydrochloride equivalent to 100 milligrams ketamine base activity.
Ketamine Hydrochloride InjectionLiquid (Solution)The drug is a sterile aqueous solution and each milliliter contains: Ketamine hydrochloride equivalent to 100 milligrams ketamine base activity.
Ketamine Hydrochloride InjectionLiquid (Solution)The drug is a sterile aqueous solution and each milliliter contains: Ketamine hydrochloride equivalent to 100 milligrams ketamine base activity.
Ketamine Hydrochloride Injection, USPLiquid (Solution)The drug is a sterile aqueous solution and each milliliter contains: Ketamine hydrochloride equivalent to 100 milligrams ketamine base activity.
Ketamine Hydrochloride Injection, USPLiquid (Solution)The drug is a sterile aqueous solution and each milliliter contains: Ketamine hydrochloride equivalent to 100 milligrams ketamine base activity.
Ketamine Hydrochloride Injection, USPLiquid (Solution)Each milliliter contains ketamine hydrochloride equivalent to 100 milligrams ketamine base activity.
Ketamine Hydrochloride Injection, USPLiquid (Solution)Each milliliter contains ketamine hydrochloride equivalent to 100 milligrams ketamine base activity.
Vetalar®Liquid (Solution)The drug is a sterile aqueous solution and each milliliter contains: Ketamine hydrochloride equivalent to 100 milligrams ketamine base activity.
Vetalar®Liquid (Solution)The drug is a sterile aqueous solution and each milliliter contains: Ketamine hydrochloride equivalent to 100 milligrams ketamine base activity.
Ketaset®Liquid (Solution)Each milliliter contains ketamine hydrochloride equivalent to 100 milligrams ketamine base activity.
Ketaset®Liquid (Solution)Each milliliter contains ketamine hydrochloride equivalent to 100 milligrams ketamine base activity.
Ketaset® PlusLiquid (Solution)The drug is a sterile aqueous solution and each milliliter contains: Ketamine hydrochloride equivalent to 100 milligrams ketamine base activity, 7.5 milligrams of promazine hydrochloride, and 0.0625 milligram of aminopentamide hydrogen sulfate, with 1:10,000 benzethonium chloride.
——100 mg / 1 mL