Ketamine Toxicity

Overview

4.5 out of 5 (8 Reviews)

Credits

1.00

Post Assessment Questions

6

Expiration Date

30 Oct 2022

Last Reviewed

30 Oct 2021

Estimated Time To Finish

60 Minutes

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Activity Description

Ketamine is a structural analog of the dissociative anesthetic and recreational drug phencyclidine (PCP). Similar to phencyclidine, ketamine causes analgesia and amnesia without the cardiovascular and respiratory depression associated with common anesthetics. Originally called CI-581, ketamine has one-tenth the potency of PCP and causes less severe dysphoria and hallucinations. Intramuscular and intravenous forms of ketamine are commonly used to provide pediatric anesthesia, especially for high-risk children or patients in limited-resource settings. In surgical settings, ketamine is typically combined with benzodiazepines, which can reduce the adverse psychological symptoms that occur during emergence. Off-label, subanesthetic doses of ketamine also have a use for acute and chronic pain management, sedation, and treatment of severe depression. Like its chemical cousin phencyclidine, ketamine’s psychomimetic effects have made it a popular recreational drug. In low doses, it’s euphoric and dissociative effects are sometimes referred to as “k-land,” whereas at high doses, the immobilizing and hallucinogenic effects are referred to as being in a “k-hole.” In the context of an illegal, recreational drug, ketamine goes by the street names “K,” “vitamin K,” “super K,” “special K,” “super C,” “special LA coke,” “jet,” “superacid,” and “green.” Ketamine toxicity can cause a variety of neurological, cardiovascular, psychiatric, urogenital and abdominal symptoms, which are dose-dependent, and whether ketamine administration was in an iatrogenic or illicit context. For example, some experts have attributed the higher incidence of ulcerative cystitis in recreational users to the adulterants with which the drug is mixed. Providers using ketamine should be aware of the various mechanisms to treat ketamine toxicity and to prevent acute complications such as rhabdomyolysis and seizures, and chronic complications such as psychiatric disturbances and ulcerative cystitis. This activity reviews the evaluation of ketamine toxicity and the role of the interprofessional team in managing this condition.

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Target Audience

This activity has been designed to meet the educational needs of physicians.

Learning Objectives

At the conclusion of this activity, the learner will be better able to:

  • Describe the chemical basis of ketamine.
  • Discuss the expected side effects of ketamine.
  • Explain the symptoms and signs of ketamine toxicity.
  • Outline medical team evaluation and management of a patient with ketamine toxicity.

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COMMERCIAL SUPPORT: This activity has received NO commercial support.

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This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the Quillen College of Medicine, East Tennessee State University, and StatPearls, LLC. The Quillen College of Medicine, East Tennessee State University is accredited by the ACCME to provide continuing medical education for physicians.

Quillen College of Medicine, East Tennessee State University designates this activity for a maximum of 1.00 AMA PRA Category 1 CreditsTM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

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  • StatPearls and ETSU reserve the right to cancel any course due to unforeseen circumstances. StatPearls and ETSU will not be responsible for other expenses incurred by the participant in the unlikely event that the program is canceled.

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  2. Review the required accreditation information:  Target audience, learning objectives, and disclosure information.
  3. Complete the entire self-study activity.
  4. Complete the post-test assessments.
  5. Successfully pass the post-test with a minimum score of 100%.
  6. Complete the evaluation survey. 
  7. Obtain a certificate.

StatPearls and ETSU adhere to ACCME Standards regarding commercial support of continuing medical education. It is the policy of StatPearls and ETSU that the faculty and planning committee disclose real or apparent conflicts of interest relating to the topics of this educational activity, that relevant conflict(s) of interest are resolved, and also that authors and editors will disclose any unlabeled/unapproved use of drug(s) or device(s) during their presentation. Detailed disclosure will be made prior to starting the activity.

The information provided at this CME/CE activity is for continuing education purposes only and is not meant to substitute for the independent medical/clinical judgment of a healthcare provider relative to diagnostic and treatment options of a specific patient’s medical condition.

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    Reviews

    Bhupendra M. on 5/8/2021

    Sarah B. on 6/19/2021

    Barbara C. on 8/20/2021

    Mark M. on 9/13/2021

    lee a. on 10/9/2021

    Dr C. on 11/15/2021

    MIA G. on 12/6/2021

    Rene G. on 12/28/2021

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