Ketamine Interactions

Ketamine interactions potentiates all non depolarizing muscle relaxants in a dose-dependent manner. Ketamine improves the intubating condition when used with rocuronium.

Halothane anesthesia by decreasing uptake, distribution, redistribution and metabolism of ketamine produces significant prolongation of its pharmacologic action on the central nervous system.

Ketamine administered in the presence of volatile anesthetics may result in hypotension due to depression of sympathetic nervous system outflow from the CNS by volatile anesthetics, thus unmasking the direct cardiac-depressant effects of ketamine interactions

However, it does not reduce the time for intubation. Pancuronium may enhance the cardiac-stimulating effects of ketamine. The duration of apnea after administration of succinylcholine is prolonged, possibly reflecting inhibition of plasma cholinesterase activity by ketamine.

Diazepam, 0.3 to 0.5 mg/kg IV, or an equivalent dose of midazolam, is also effective in preventing the cardiac-stimulating effects of ketamine. Benzodiazepines also prevent as well as decrease the reactions of emergence delirium by Ketamine interactions

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