Khác biệt giữa các bản “Ketamin”

n
→‎top: replaced: chloride]] → clorua]] using AWB
n (Đã khóa “Ketamin” ([Sửa đổi=Chỉ cho phép các thành viên tự động xác nhận] (hết hạn 15:24, ngày 21 tháng 3 năm 2018 (UTC)) [Di chuyển=Cấm mọi thành viên (trừ bảo quản viên)] (vô thời hạn)))
n (→‎top: replaced: chloride]] → clorua]] using AWB)
<!--Pharmacokinetic data-->
| bioavailability = • [[Intravenous therapy|Intravenous]]: 100%<ref name="MathewZarate2016">{{cite book|author1=Sanjay J. Mathew|author2=Carlos A. Zarate, Jr.|title=Ketamine for Treatment-Resistant Depression: The First Decade of Progress|url=https://books.google.com/books?id=QDOgDQAAQBAJ&pg=PA22|date=25 November 2016|publisher=Springer|isbn=978-3-319-42925-0|pages=8–10, 14–22|deadurl=no|archiveurl=https://web.archive.org/web/20170908185726/https://books.google.com/books?id=QDOgDQAAQBAJ&pg=PA22|archivedate=8 September 2017|df=dmy-all}}</ref><br />• [[Intramuscular injection|Intramuscular]]: 93%<ref name="MathewZarate2016" /><br />• [[Subcutaneous injection|Subcutaneous]]: high<ref name="Mao2016">{{cite book|author=Jianren Mao|title=Opioid-Induced Hyperalgesia|url=https://books.google.com/books?id=_VrvBQAAQBAJ&pg=PA127|date=19 April 2016|publisher=CRC Press|isbn=978-1-4200-8900-4|pages=127–|deadurl=no|archiveurl=https://web.archive.org/web/20170908185726/https://books.google.com/books?id=_VrvBQAAQBAJ&pg=PA127|archivedate=8 September 2017|df=dmy-all}}</ref><br />• [[Epidural administration|Epidural]]: 77%<ref name="Kintz2014">{{cite book|author=Pascal Kintz|title=Toxicological Aspects of Drug-Facilitated Crimes|url=https://books.google.com/books?id=YgnUAgAAQBAJ&pg=PA87|date=22 March 2014|publisher=Elsevier Science|isbn=978-0-12-416969-2|pages=87–|deadurl=no|archiveurl=https://web.archive.org/web/20170908185726/https://books.google.com/books?id=YgnUAgAAQBAJ&pg=PA87|archivedate=8 September 2017|df=dmy-all}}</ref><br />• [[Intranasal administration|Intranasal]]: 25–50%<ref name="MathewZarate2016" /><ref name=sinner>{{cite book |last1= Sinner |first1= B |last2 =Graf |first2= BM |chapter= Ketamine |title= Modern Anesthetics |editor-last1= Schüttler |editor-first1= J |editor-last2= Schwilden |editor-first2= H |series= Handbook of Experimental Pharmacology |year= 2008 |volume= 182 |pages= 313–33 |isbn= 978-3-540-72813-9 |doi=10.1007/978-3-540-74806-9_15 |pmid=18175098}}</ref><br />• [[Sublingual administration|Sublingual]]: 30%<ref name="MathewZarate2016" /><br />• [[Rectal administration|Rectal]]: 30%<ref name="Nemeroff2017">{{cite book |author1=Alan F. Schatzberg |author2=Charles B. Nemeroff |title=The American Psychiatric Association Publishing Textbook of Psychopharmacology, Fifth Edition|url=https://books.google.com/books?id=KfHEDgAAQBAJ&pg=PA550|year=2017|publisher=American Psychiatric Pub|isbn=978-1-58562-523-9|pages=550–|deadurl=no|archiveurl=https://web.archive.org/web/20170908185726/https://books.google.com/books?id=KfHEDgAAQBAJ&pg=PA550|archivedate=8 September 2017|df=dmy-all}}</ref><br />• [[Oral administration|By mouth]]: 16–24%<ref name="Kintz2014" /><ref name="DickmanSchneider2016">{{cite book|author1=Andrew Dickman|author2=Jennifer Schneider|title=The Syringe Driver: Continuous Subcutaneous Infusions in Palliative Care|url=https://books.google.com/books?id=jbUSDQAAQBAJ&pg=PA114|date=22 September 2016|publisher=Oxford University Press|isbn=978-0-19-873372-0|pages=114–|deadurl=no|archiveurl=https://web.archive.org/web/20170908185726/https://books.google.com/books?id=jbUSDQAAQBAJ&pg=PA114|archivedate=8 September 2017|df=dmy-all}}</ref>
| protein_bound = 12–47% (low)<ref name="sinnerKintz2014" /><ref name="DowdJohnson2016sinner" /><ref name="Kintz2014DowdJohnson2016" />
| metabolism = [[Liver]] ([[demethylation|''N''-demethylation]]):<ref name="MathewZarate2016" /><ref>{{Cite journal |last1= Hijazi |first1= Y |last2= Boulieu |first2= R |title= Contribution of CYP3A4, CYP2B6, and CYP2C9 isoforms to N-demethylation of ketamine in human liver microsomes |journal= [[Drug Metabolism and Disposition]] |volume= 30 |issue= 7 |pages= 853–8 |date= July 2002 |pmid= 12065445 |doi= 10.1124/dmd.30.7.853}}</ref><br />• Major: [[CYP3A4]]<br />• Minor: [[CYP2B6]], [[CYP2C9]]
| metabolites = • [[Norketamine]]<br />• [[Dehydronorketamine]]<br />• [[Hydroxynorketamine]]<br />• [[Conjugation (biochemistry)|Conjugates]]<ref name="Levine2003">{{cite book|author=Barry Levine|title=Principles of Forensic Toxicology|url=https://books.google.com/books?id=k7BInEQ-iqgC&pg=PA282|year=2003|publisher=Amer. Assoc. for Clinical Chemistry|isbn=978-1-890883-87-4|pages=282–|deadurl=no|archiveurl=https://web.archive.org/web/20170908185726/https://books.google.com/books?id=k7BInEQ-iqgC&pg=PA282|archivedate=8 September 2017|df=dmy-all}}</ref>
| onset = • Intravenous: seconds<ref name="sinner" /><br />• Intramuscular: 1–5 min<ref name="sinner" /><ref name="Quibell2011">{{cite journal |last= Quibell |first= R |last2= Prommer |first2= EE |last3= Mihalyo |first3= M |last4= Twycross |first4= R |last5= Wilcock |first5= A |displayauthors= 4 |title= Ketamine* |journal= [[Journal of Pain and Symptom Management]] |date= March 2011 |volume= 41 |issue= 3 |pages= 640–9 |doi= 10.1016/j.jpainsymman.2011.01.001 |pmid= 21419322 |url= http://www.jpsmjournal.com/article/S0885-3924%2811%2900046-7/fulltext |type= Therapeutic Review}}</ref><br />• Subcutaneous: 15–30 min<ref name="Quibell2011">{{cite journal |last= Quibell |first= R |last2= Prommer |first2= EE |last3= Mihalyo |first3= M |last4= Twycross |first4= R |last5= Wilcock |first5= A |displayauthors= 4 |title= Ketamine* |journal= [[Journal of Pain and Symptom Management]] |date= March 2011 |volume= 41 |issue= 3 |pages= 640–9 |doi= 10.1016/j.jpainsymman.2011.01.001 |pmid= 21419322 |url= http://www.jpsmjournal.com/article/S0885-3924%2811%2900046-7/fulltext |type= Therapeutic Review}}</ref><br />• Insufflation: 5–10 min<ref name="sinner" /><br />• By mouth: 15–30 min<ref name="sinner" /><ref name="Quibell2011">{{cite journal |last= Quibell |first= R |last2= Prommer |first2= EE |last3= Mihalyo |first3= M |last4= Twycross |first4= R |last5= Wilcock |first5= A |displayauthors= 4 |title= Ketamine* |journal= [[Journal of Pain and Symptom Management]] |date= March 2011 |volume= 41 |issue= 3 |pages= 640–9 |doi= 10.1016/j.jpainsymman.2011.01.001 |pmid= 21419322 |url= http://www.jpsmjournal.com/article/S0885-3924%2811%2900046-7/fulltext |type= Therapeutic Review}}</ref>
| elimination_half-life = • Ketamine: 2.5–3 hours<ref name="sinnerMathewZarate2016" /><ref name="MathewZarate2016sinner" /><br />• Norketamine: 12 hours<ref name="Quibell2011">{{cite journal |last= Quibell |first= R |last2= Prommer |first2= EE |last3= Mihalyo |first3= M |last4= Twycross |first4= R |last5= Wilcock |first5= A |displayauthors= 4 |title= Ketamine* |journal= [[Journal of Pain and Symptom Management]] |date= March 2011 |volume= 41 |issue= 3 |pages= 640–9 |doi= 10.1016/j.jpainsymman.2011.01.001 |pmid= 21419322 |url= http://www.jpsmjournal.com/article/S0885-3924%2811%2900046-7/fulltext |type= Therapeutic Review}}</ref>
| duration_of_action = • Intramuscular: 0.5–2 hours<ref name="Quibell2011">{{cite journal |last= Quibell |first= R |last2= Prommer |first2= EE |last3= Mihalyo |first3= M |last4= Twycross |first4= R |last5= Wilcock |first5= A |displayauthors= 4 |title= Ketamine* |journal= [[Journal of Pain and Symptom Management]] |date= March 2011 |volume= 41 |issue= 3 |pages= 640–9 |doi= 10.1016/j.jpainsymman.2011.01.001 |pmid= 21419322 |url= http://www.jpsmjournal.com/article/S0885-3924%2811%2900046-7/fulltext |type= Therapeutic Review}}</ref><br />• Insufflation: 45–60 min<ref name="sinner" /><br />• By mouth: 1–6+ hours<ref name="sinner" /><ref name="Quibell2011">{{cite journal |last= Quibell |first= R |last2= Prommer |first2= EE |last3= Mihalyo |first3= M |last4= Twycross |first4= R |last5= Wilcock |first5= A |displayauthors= 4 |title= Ketamine* |journal= [[Journal of Pain and Symptom Management]] |date= March 2011 |volume= 41 |issue= 3 |pages= 640–9 |doi= 10.1016/j.jpainsymman.2011.01.001 |pmid= 21419322 |url= http://www.jpsmjournal.com/article/S0885-3924%2811%2900046-7/fulltext |type= Therapeutic Review}}</ref><ref name="sinner" />
| excretion = • [[Urine]]: 91%<ref name="MathewZarate2016" /><br />• [[Feces]]: 1–3%<ref name="MathewZarate2016" />
 
| CAS_number_Ref = {{cascite|correct|??}}
| CAS_number = 6740-88-1
| CAS_supplemental = <br />1867-66-9 ([[hydrochloridehydroclorua]])<br />33643-46-8 ([[esketamine]])<br />33643-49-1 ([[arketamine]])
| ATC_prefix = N01
| ATC_suffix = AX03
}}
 
'''Ketamin''' được bán dưới nhãn hiệu '''Ketalar''' và một số tên khác, là một loại thuốc được sử dụng chủ yếu để bắt đầu và duy trì [[gây mê]]<ref name=KetPres2013 />. Nó gây ra một tình trạng giống như trạng thái giống như bị thôi miên, làm [[Thuốc giảm đau|giảm đau]], an thần, và [[mất trí nhớ]]<ref name="GreenRoback2011" />. Các tác dụng khác bao gồm giảm cơn đau mãn tính và an thần trong hồi sức cấp cứu.<ref>{{cite journal|last1=Zgaia|first1=AO|last2=Irimie|first2=A|last3=Sandesc|first3=D|last4=Vlad|first4=C|last5=Lisencu|first5=C|last6=Rogobete|first6=A|last7=Achimas-Cadariu|first7=P|title=The role of ketamine in the treatment of chronic cancer pain.|journal=Clujul Medical |date=2015|volume=88|issue=4|pages=457–61|pmid=26733743|doi=10.15386/cjmed-500|pmc=4689236}}</ref><ref>{{cite journal|last1=Zapantis|first1=A|last2=Leung|first2=S|title=Tolerance and withdrawal issues with sedation.|journal=Critical Care Nursing Clinics of North America|date=September 2005|volume=17|issue=3|pages=211–23|pmid=16115529|doi=10.1016/j.ccell.2005.04.011}}</ref> Các chức năng tim, khả năng hô hấp và thở máy nói chung vẫn hoạt động khi dùng thuốc này<ref name="GreenRoback2011">{{cite journal |last1= Green |first1= SM |last2= Roback |first2= MG |last3= Kennedy |first3= RM |last4= Krauss |first4= B |title= Clinical Practice Guideline for Emergency Department Ketamine Dissociative Sedation: 2011 Update |journal= [[Annals of Emergency Medicine]] |volume= 57 |issue= 5 |year= 2011 |pages= 449–61 |pmid= 21256625 |doi= 10.1016/j.annemergmed.2010.11.030 |url= http://www.annemergmed.com/article/S0196-0644%2810%2901827-5/fulltext}}</ref>. Các hiệu ứng thường bắt đầu trong vòng năm phút khi được tiêm và kéo dài đến 25 phút.<ref name=Mary2014KetPres2013 /><ref name=KetPres2013Mary2014 />
 
Các phản ứng phụ thường gặp bao gồm các phản ứng tâm lý khi thuốc hết tác dụng.<ref name="StrayerNelson2008" /> Những phản ứng này có thể bao gồm kích động, nhầm lẫn hoặc [[ảo giác]]<ref name=KetPres2013>{{cite web|title=Ketamine Injection|url=https://www.drugs.com/pro/ketamine-injection.html|website=[[Drugs.com]]|accessdate=1 December 2014|deadurl=no|archiveurl=https://web.archive.org/web/20141210181630/http://www.drugs.com/pro/ketamine-injection.html|archivedate=10 December 2014|df=dmy-all}}</ref><ref name="StrayerNelson2008">{{cite journal |last1= Strayer |first1= RJ |last2= Nelson |first2= LS |year= 2008 |title= Adverse events associated with ketamine for procedural sedation in adults |journal= [[American Journal of Emergency Medicine]] |volume= 26 |issue= 9 |pages= 985–1028 |doi= 10.1016/j.ajem.2007.12.005 |pmid= 19091264 |url= https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0026626/ |deadurl= no |archiveurl= https://web.archive.org/web/20170908185727/https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0026626/ |archivedate= 8 September 2017 |df= dmy-all }}</ref><ref name=KetSide2014 />. [[Cao huyết áp]] và chứng run cơ là hiệu ứng phụ xảy ra tương đối phổ biến, trong khi [[huyết áp thấp]] và giảm nhịp thở ít phổ biến hơn<ref name=KetPres2013 /><ref name=KetSide2014>{{cite web|title=Ketamine Side Effects|url=https://www.drugs.com/sfx/ketamine-side-effects.html|website=drugs.com|accessdate=1 December 2014|deadurl=no|archiveurl=https://web.archive.org/web/20141210173330/http://www.drugs.com/sfx/ketamine-side-effects.html|archivedate=10 December 2014|df=dmy-all}}</ref>. Sự co thắt thanh quản hiếm khi xảy ra.<ref name=KetPres2013 /> Ketamine đã được phân loại như một [[chất đối kháng thụ thể NMDA]] nhưng cơ chế của nó chưa được hiểu rõ tính đến năm 2017.<ref name=ACS2017>{{Cite journal|last=Tyler|first=MW|last2=Yourish|first2=HB|last3=Ionescu|first3=DF|last4=Haggarty|first4=SJ|date=2017|title=Classics in Chemical Neuroscience: Ketamine|journal=ACS Chemical Neuroscience|doi=10.1021/acschemneuro.7b00074|issn=1948-7193|pmid=28418641}}</ref>