Ketamina
Ketamine
Ketamine Hydrochloride
También conocido como: Ketaset · Ketaflo · Ketalar · Ketaject · VetaKet · Anaestamine · Anesketin · Ketavet · Narketan-10 · Vetalar-V · CI-581 · CL-369 · CN-52372-2 · ketamini hydrochloridum · Ketamine hydrochloride
Revisado por el equipo veterinario de VetSheetActualizado 5 abr 2026Referencia veterinaria basada en la evidencia
Evidencia de dosis v13 auditada
Evidencia estructurada para el cálculoKetamine/benzodiazepine combinations — Postoperative analgesia
Requiere verificación veterinaria
NA
Contexto clínico obligatorio (4)
- 1. Ketamine is used in many different combinations with other agents. The following are representative, but not necessarily inclusive; it is suggested to refer to a recent veterinary anesthesia reference for more information. 31,32
- 2. Do not confuse IV CRI dosages listed as mg/kg/HOUR with those listed as µg/kg/MINUTE.
- a) Ketamine/benzodiazepine combinations:
- Ketamine injection should be stored between 15°C to 30°C (59°F-86°F) and protected from light. The discard dates after first vial puncture vary by manufacturer; refer to the specific product label for further information.
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Resumen
Ketamina es un anestésico general disociativo y analgésico de acción rápida ampliamente utilizado en medicina veterinaria.
- Clase de fármaco: Es un derivado de la fenciclidina (PCP).
- Efectos clínicos: Induce un estado cataléptico caracterizado por una analgesia somática profunda, amnesia y disociación entre los sistemas talamocortical y límbico. A diferencia de los anestésicos tradicionales, no induce la etapa III de la anestesia.
- Preservación de reflejos: Los pacientes generalmente mantienen los reflejos de los nervios craneales, incluidos los reflejos faríngeos, laríngeos, corneales y pedales. Los ojos a menudo permanecen abiertos.
- Cardiovascular: Generalmente estimula el sistema cardiovascular (aumentando la frecuencia cardíaca, la presión arterial y el gasto cardíaco) debido al aumento del tono simpático, lo que lo hace útil en pacientes con compromiso hemodinámico (aunque está contraindicado en la miocardiopatía hipertrófica).
Perla clínica: Debido a que la ketamina por sí sola causa rigidez muscular y carece de analgesia visceral, casi siempre se administra junto con relajantes musculares (por ejemplo, benzodiazepinas como midazolam o diazepam) o agonistas alfa-2 (por ejemplo, dexmedetomidina, xilazina) para asegurar una inducción suave, una relajación muscular adecuada y una recuperación más tranquila.
Mecanismo de acción
Ketamine exerts its effects through multiple central nervous system pathways:
- NMDA Receptor Antagonism: Acts as a non-competitive antagonist at the N-methyl-D-aspartate (NMDA) receptor → binds to the PCP site inside the calcium channel pore → prevents glutamate-mediated calcium influx → blocks central sensitization and prevents the "wind-up" phenomenon associated with chronic or severe pain.
- Neurotransmitter Modulation: Inhibits GABA and blocks the reuptake of serotonin, norepinephrine, and dopamine in the CNS.
- CNS Dissociation: Depresses the thalamoneocortical system (responsible for sensory perception) while simultaneously activating the limbic system (involved in memory and emotion).
- Sympathetic Stimulation: Increases sympathetic tone by promoting norepinephrine release → leads to increased heart rate, cardiac output, and blood pressure. Note: Ketamine has direct negative inotropic effects on the myocardium, which are usually masked by this sympathetic surge unless the patient is catecholamine-depleted.
Seguridad y advertencias
Contraindicaciones
- Prior hypersensitivity reactions to ketamine
- Animals intended for human consumption
- Use as a sole agent for major surgery (due to poor muscle relaxation and visceral analgesia)
- Increased cerebrospinal fluid (CSF) pressure or head trauma
- Significant hypertension, heart failure, or arterial aneurysms
- Hypertrophic cardiomyopathy (HCM) in cats
- Increased intra-ocular pressure or open globe injuries (relative)
- Procedures involving the pharynx, larynx, or trachea (relative)
- Preexisting seizure disorders (use with extreme caution)
- Animals whose eyes are at risk of perforation
- Raised intraocular pressure (IOP)
- Raised intracranial pressure (ICP)
Efectos adversos
- Hypertension
- Hypersalivation
- Respiratory depression (at high doses or rapid IV administration)
- Hyperthermia (especially in cats)
- Emesis
- Vocalization
- Erratic and prolonged recovery (emergence delirium)
- Dyspnea
- Spastic jerking movements and muscular tremors
- Seizures (up to 20% of cats at therapeutic doses)
- Hypertonicity and opisthotonos
- Cardiac arrest
- Pain after IM injection
- Eyes remain open (risk of corneal drying/ulceration)
- Cardiovascular depression and arrhythmias (in animals with high sympathetic tone, shock, or severe CV disease)
- Tachycardia (following high IV doses)
- Marked respiratory depression (in some animals)
- Skeletal muscle hypertonicity and spontaneous movement (if used alone)
- Spacey, abnormal behaviour or dysphoria during recovery (1-2 hours)
- Drug accumulation and prolonged recovery (with prolonged infusion)
Precauciones
Cardiovascular Caution: Ketamine increases heart rate, blood pressure, and myocardial oxygen consumption. Avoid in patients where this is detrimental (e.g., unstable shock, congestive heart failure, hypertrophic cardiomyopathy).
Ocular Care: Cats' eyes remain open after receiving ketamine. Protect from injury and apply an ophthalmic lubricant (e.g., Lacri-Lube) to prevent excessive corneal drying.
- Hepatic/Renal Insufficiency: Use with caution. In cats, ketamine is excreted almost exclusively via the kidneys; reduce doses or use cautiously in feline renal disease.
- Sympathetic Tone: Use with caution in animals with preexisting increased sympathetic tone (e.g., pheochromocytoma, hyperthyroidism).
- Recovery: Minimize exposure to handling or loud noises during the recovery period to reduce the incidence of emergence reactions (delirium, thrashing), but continue to monitor vital signs closely.
- Hemorrhage: Because ketamine can increase blood pressure, careful control of post-surgical hemorrhage (e.g., declawing) is required.
Interacciones farmacológicas
May prolong the anesthetic actions of ketamine
May prolong the recovery time after ketamine anesthesia
Recovery rates may be prolonged and the cardiac stimulatory effects of ketamine may be inhibited; close monitoring of cardiac status is recommended
Recommended not to use ivermectin in reptiles within 10 days of ketamine
May cause enhanced or prolonged respiratory depression
May induce severe hypertension and tachycardia; beta-blockers may be of benefit in treating these effects
Synergistic anaesthesia and prevention of muscle hypertonicity. Reversal of the alpha-2 agonist must be delayed until 45 minutes after ketamine administration to prevent unopposed ketamine excitation.
Synergistic anaesthesia and prevention of ketamine-induced skeletal muscle hypertonicity.
Monitorización
- Level of anesthesia and analgesia
- Respiratory function
- Cardiovascular status (heart rate, rhythm, blood pressure)
- Eyes (monitor to prevent drying or injury)
- Body temperature (monitor for hyperthermia or hypothermia)
- Heart rate and rhythm
- Respiratory rate and depth
- Depth of anaesthesia
- Corneal lubrication status
- Quality of recovery (monitor for dysphoria)
Farmacocinética
Vida media
Absorción
After IM injection in the cat, peak levels occur in approximately 10 minutes. Sublingual spray in cats is absorbed enough to have pharmacologic action.
Distribución
Distributed into all body tissues rapidly, with highest levels found in the brain, liver, lung, and fat. Plasma protein binding is approximately 50% in the horse, 53% in dogs, and 37-53% in cats.
Metabolismo
In most species, metabolized in the liver principally by demethylation and hydroxylation. One active metabolite, nor-ketamine, has 10-30% of the activity of the parent compound. In cats, ketamine is almost exclusively excreted unchanged.
Eliminación
Eliminated primarily in the urine. Redistribution out of the CNS is more of a factor in determining duration of anesthesia than is the elimination half-life.
Sobredosis
Ketamine has a wide therapeutic index (approximately 5 times greater than pentobarbital).
- Signs of Toxicity: When given too rapidly or in excessive doses, significant respiratory depression may occur.
- Treatment: Treatment using mechanically assisted respiratory support is recommended over the use of analeptic agents. In cats, yohimbine combined with 4-aminopyridine has been suggested for use as a partial antagonist.
Productos disponibles
Formulaciones
- Injection: 10 mg/mL
- Injection: 50 mg/mL
- Injection: 100 mg/mL
- Injectable: 100 mg/ml solution
Veterinario
- Ketamine HCl for Injection: 100 mg/mL in 10 mL vials (Ketaject, Ketaset, Keta-sthetic, Vetalar, VetaKet)
- Anaestamine 100 mg/ml injection
- Anesketin 100 mg/ml injection
- Ketaset 100 mg/ml injection
- Ketavet 100 mg/ml injection
- Narketan-10 100 mg/ml injection
- Vetalar-V 100 mg/ml injection
Etiquetado para humanos
- Ketamine HCl Injection: 10 mg/mL in 20 mL vials
- Ketamine HCl Injection: 50 mg/mL in 10 mL vials
- Ketamine HCl Injection: 100 mg/mL in 5 mL vials (Ketalar)
Estado regulador
POM-V CD SCHEDULE 2
Sin datos reguladores para: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Almacenamiento y estabilidad
Store between 15-30°C (59-86°F) and protect from light. Solution may darken upon prolonged exposure to light, which does not affect potency. Do not use if precipitates appear. Do not mix with barbiturates or diazepam in the same syringe or IV bag as precipitation may occur.
Información para el cliente
Importante: La ketamina es una sustancia controlada y solo es administrada por profesionales veterinarios en un entorno clínico.
- Cuidado de los ojos: Los ojos de su mascota pueden permanecer abiertos mientras esté bajo los efectos de este medicamento. El equipo veterinario aplicará un ungüento protector ocular para evitar la sequedad y lesiones.
- Fase de recuperación: Mantenga a su mascota en un ambiente tranquilo y con poca luz mientras se recupera. Minimice los ruidos fuertes, los movimientos bruscos y el manejo excesivo para evitar reacciones de sobresalto, movimientos erráticos o alucinaciones a medida que el efecto del fármaco desaparece.
- Qué observar: Esté atento a cualquier espasmo inusual, somnolencia prolongada o comportamiento anormal, e infórmelo a su veterinario.
La referencia de medicamentos de VetSheet está destinada a profesionales veterinarios autorizados como ayuda para la toma de decisiones clínicas, no como sustituto del criterio profesional ni del prospecto actual del fabricante.