KETAMINE INJECTION, BP

USDailyMed:Ketamine AU:B3 N01AX03(WHO) AU:S8(Controlled drug)BR:Class C1(Other controlled substances)CA:Schedule IDE: § 48AMG/§ 1MPAV(Prescription only)UK:Class B (Class A if prepared as an injection)US:Schedule IIIUN:Unscheduled (Rx only)IN:Schedule X Intravenous: 100%Intramuscular: 93%Epidural: 77%Intranasal: 45–50%Sublingual: 24–30%Rectal: 25–30%By mouth: 16–20% Major:CYP3A4,CYP2B6 NorketamineDehydronorketamineHydroxynorketamine Intravenous: secondsIntramuscular: 1–5 minSubcutaneous: 15–30 minInsufflation: 5–10 minBy mouth: 15–30 min Ketamine: 2.5–3 hoursNorketamine: 12 hours Intramuscular: 0.5–2 hoursInsufflation: 45–60 minBy mouth: 1–6+ hours Urine: 91%Feces: 3% (RS)-2-(2-Chlorophenyl)-2-(methylamino)cyclohexanone 6740-88-1Y33643-46-8 (esketamine)33643-49-1 (arketamine)HCl:1867-66-9Y 33643-46-8 (esketamine)33643-49-1 (arketamine) 3821 4233 DB01221Y 3689Y 690G0D6V8H D08098YHCl:D00711Y CHEBI:6121Y ChEMBL742Y DTXSID8023187 Interactive image Esketamine(S(+)-isomer)Arketamine(R(−)-isomer) Clc1ccccc1C2(NC)CCCCC2=O InChI=1S/C13H16ClNO/c1-15-13(9-5-4-8-12(13)16)10-6-2-3-7-11(10)14/h2-3,6-7,15H,4-5,8-9H2,1H3YKey:YQEZLKZALYSWHR-UHFFFAOYSA-NY Ketamineis acyclohexanone-derivedgeneral anestheticandNMDA receptor antagonistwithanalgesicandhallucinogenicproperties, used medically foranesthesia,depression, andpain management.Ketamine exists as its twoenantiomers,S- (esketamine)andR- (arketamine), and has antidepressant action likely involving NMDA antagonism as well as other mechanisms. At anesthetic doses, ketamine induces a state of dissociative anesthesia, atrance-like state providing pain relief,sedation, andamnesia.Its distinguishing features as an anesthetic are preserved breathing and airway reflexes, stimulated heart function with increasedblood pressure, and moderatebronchodilation.As an anesthetic, it is used especially in trauma,emergency, andpediatriccases. At lower, sub-anesthetic doses, it is used as a treatment forpainandtreatment-resistant depression. Ketamine is legally used in medicine but is also tightly controlled, as it is used as arecreational drugfor itshallucinogenicanddissociativeeffects.When used recreationally, it is found both in crystalline, powder and liquid form, and is often referred to by users as "Ket", "Special K" or simply "K". The long-term effects of repeated use are largely unknown and are an area of active investigation.Liver and urinary toxicity have been reported among regular users of high doses of ketamine for recreational purposes.Ketamine can causedissociationand nausea, and other adverse effects, and iscontraindicatedin severeheartorliver disease, and uncontrolledpsychosis. Ketamine's clinical and antidepressant effects can be influenced by co-administration of other drugs, though these interactions are variable and not yet fully understood. Ketamine was first synthesized in 1962; it was derived fromphencyclidinein pursuit of a safer anesthetic with fewer hallucinogenic effects.It was approved for use in the United States in 1970.It has been regularly used inveterinary medicineand was extensively used forsurgical anesthesiain theVietnam War.It later gained prominence for its rapid antidepressant effects discovered in 2000, marking a major breakthrough in depression treatment. Racemic ketamine, especially at higher doses, may be more effective and longer-lasting than esketamine in reducing depression severity.It is on theWorld Health Organization's List of Essential Medicines.It is available as ageneric medication.