KETAMIN
Ketamin developed in 1960,as an anaesthetic agent.
It is a phencyclidine derivative.
Commonly used as an analgesic in emergency medicine, and an adjuvant drug in perioperative setting, and a third line adjuvant drug in opioid resistant pain in palliative care.
Recently it started using for treatment of depression and mood disorders.
MECHANISM OF ACTION
Ketamin interacts with N -methyl- D- aspartate(NMDA) receptors, opioid receptors ,monoaminergic receptors,muscarinic receptors and voltage sensitive Ca ion channels. Unlike other general anaesthetic agents, ketamin does not interact with GABA receptors.
INDICATIONS
General anaesthesia
Supplimenting low-potency agents such as nitrous oxide
Short term procedural sedation
Rapid sequence intubation
SIDE EFFECTS
Anaphylaxis
Arrhythmia, elevated BP, bradycardia
Anorexia, nausea, vomiting
Muscle stiffness/spasm/toxic clonic movements
Confusion, seizures
Amnesia, anxiety, confusion
Apnea, laryngospasm
MORPHINE
Morphine is an analgesic of opiate family.
First obtained from poppy seeds, in 1805
Acts directly on the central nervous system to reduce the feeling of pain.
Mechanism of action
Morphine had an affinity to delta, kappa and mu opioid receptors, it binds to mu opioid receptors in the central nervous system, and the peripheral nervous system . The net effect of morphine is the activation of descending inhibitory pathways of CNS and PNS. Which results in overall inhibition of nociceptive receptors.
Indications
For chronic, moderate to severe pain
Short term management of pain
Side effects
Constipation
Decreased peristalsis
Respiratory depression
Light headedness
Nausea
Vomiting
Depression
Urinary retention
Dizziness
Euphoria
Disphoria
Agitation
Drymouth
Anorexia
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