Ketamine: An important drug with a serious adverse effect - a review

Abstract

Ketamine is a hydrosoluble aryl-cyclo-alkylamine with a molecular mass of 238 g/mol and a pKa 7.5. Only 10-30% of the Ketamine binds to plasma protiens 13 and has an extensive volume of distribution. Ketamine is mostly metabolized in norketamine (80%) and 6-hydroxy-norketamine (15%) by a microsomal enzyme system (N-demethylation), finally excreted in bile and urine after conjugation in the liver by glucuronidation. This metabolism involves liver, kidneys, intestine and lungs. 13 It has a half-life of three hours. Cytochrome P450 system is responsible for ketamine metabolism, and several microsomal enzymes are responsible for norketamine demethylation. 14 Norketamine pharmacokinetics Norketamine appears in blood 2-3 min after intravenous administration of ketamine bolus and reaches a peak about 30 min