Ketamine Barbiturates

Schedule III Anabolic steroids, Barbiturates, Ketamine, LSD precursors... 

Hypnotics. Common hypnotics are thiopental, propofol, midazolam, etomidate, ketamine and inhaled anesthetics. The incidence of hypersensitivity reactions with thiopental is rare. Recently, thiopental was involved in less than 1% of allergic reactions in France [9]. Ever since Cremophor EL, used as a solvent for some non-barbiturate hypnotics, has been avoided, many previously reported hypersensitivity reactions have disappeared. In the last French surveys, reactions to propofol accounted for less than 2.5% of allergic reactions, and reactions to midazolam, etomidate or ketamine appear to be really rare [9]. Finally, no immune-mediated immediate hypersensitivity reaction involving isoflurane, desflurane or sevoflurane has been reported despite their wide use. 

Schedule III—The drug or other substance has (1) a potential for abuse less than the drugs or other substances in Schedules I and II, (2) a currently accepted medical use in treatment in the United States, and (3) abuse of the drug or other substance may lead to moderate or low physical dependence or high psychological dependence. Examples ketamine, anabolic steroids, some barbiturates. 

Drugs acting on GABA/glutamate - hypnotics/anxiolytics barbiturates, benzodiazepines, chlormethiazole, chloral derivatives, baclofen - anticonvulsants phenobarbitone, primidone, phe-nytoin, sodium, valproate, carbamazepine - alcohol, phencyclidine, ketamine... 

It is a new non-barbiturate anaesthetic agent and pharmacologically related to phencyclidine, a hallucinogen. Intravenous ketamine produces unconsciousness and analgesia within 30 seconds. It can be given by intramuscular route also. It acts on the cerebral cortex and subcortical areas. 

Reduction in the anesthetic dose of the most commonly used barbiturate, methohexital, or the use of alternate agents such as ketamine or etomidate... 

Barbiturates may precipitate episodes of acute intermittent porphyria (AIP) and their use is contraindicated in patients who are predisposed to this condition. Some animal models indicate that ketamine, etomidate, and the benzodiazepines may be porphyrinogenic and propofol is considered to be the intravenous anaesthetic of choice in AlP-prone patients. 

See also Antidepressants Barbiturates Benzodiazepines GHB Herbal drugs Ketamine Melatonin Methaqualone Rohypnol... 

Several drugs are used intravenously, alone or in combination with other drugs, to achieve an anesthetic state (as components of balanced anesthesia) or to sedate patients in intensive care units who must be mechanically ventilated. These drugs include the following (1) barbiturates (thiopental, methohexital) (2) benzodiazepines (midazolam, diazepam) (3) opioid analgesics (morphine, fentanyl, sufentanil, alfentanil, remifentanil) (4) propofol (5) ketamine and (6) miscellaneous drugs (droperidol, etomidate, dexmedetomidine). Figure 25-2 shows the structures of... 

Among the drugs which are known to interact with barium, the barbiturates sodium pentobarbital and phenobarbital were found to have an increased depressive effect on the hearts of rats exposed to barium (Kopp et al. 1985 Perry et al. 1983, 1989). This hypersensitivity of the cardiovascular system to anesthesia was not observed in similarly treated animals that were anesthetized with xylazine plus ketamine. Results of the study indicated that the hypersensitivity was specific to the barbiturates and not a generalized effect of anesthesia (Kopp et al. 1985). 

Species Barbiturate Overdose Route Chloralhydrate Overdose Route Ketamine Overdose Route... 

Alcohol is just one of many drugs used to facilitate rape. Others include marijuana, cocaine, benzodiazepines, barbiturates, chloral hydrate, methaqualone ( quaaludes ), heroin, morphine, and LSD. Three of the more commonly used drugs today—and the ones that are the focus of this book—are Rohypnol, gamma hydroxybutyrate ( GHB ), and ketamine. Though Rohypnol and GHB were initially used as recreational drugs at clubs and raves, word soon spread among American youth that these drugs could be used quite effectively to commit rape. 

Clinical concentrations of inhalational anesthetics enhance the capacity of glycine to activate glycine-gated chloride channels (glycine receptors), which play an important role in inhibitory neurotransmission in the spinal cord and brainstem. Propofol, neurosteroids, and barbiturates also potentiate glycine-activated currents etomidate and ketamine do not. Subanesthetic concentrations of the inhalational anesthetics inhibit some classes of neuronal nicotinic ACh receptors these actions do not appear to mediate anesthetic immobilization but could mediate other components of anesthesia such as analgesia or amnesia. 

The dose requirement of inhalational anaesthetics and barbiturate anaesthetics is reduced by nitrous oxide, and the effect of ketamine may be prolonged by barbiturate anaesthetics. 

The manufacturers of ketamine note that barbiturates may prolong the effects of ketamine and delay recovery." "... 

Ketamine is an excellent anesthetic, analgesic, and sedative in specialized settings. It can be used in patients who cannot tolerate barbiturates, in settings where cardiovascular depression must be avoided, and in patients with refractory bronchospasm. It is useful in one-lung ventilation, asthmatic patients, or when there is need for an intramuscular route of administration. It is very helpful in specific situations such as the need for anesthesia in uncontrollable, mentally retarded patients. It can be simply mixed with syrup if oral premedication is desired. 

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