Ketamine

Name:

Ketamine, "K", Special K, Ketalar (prescription)

Effects:

Trance-like state, pain relief, stimulant (low doses), hallucinations, psychedelic dreams

Side effects: 

Nausea, loss of motor control, drowsiness, unconsciousness, moderate pupil dilatation, ketamine-induced ulcerative cystitis including urge incontinence, decreased bladder compliance, decreased bladder volume, detrusor overactivity, and painful blood in urine. Laryngospasms. Ketamine increases intracranial cerebrospinal fluid pressure. 

Ketamine is considered porphyrinogenic, that is, it may provoke an attack of acute porphyria in susceptible persons.

Mechanism of action: 

Ketamine acts as a selective antagonist of the NMDA receptor, an ionotropic glutamate receptor. It binds specifically to the dizocilpine (MK-801) site of the NMDA receptor, near the channel pore, and is an uncompetitive antagonist. Ketamine may also interact with and inhibit the NMDAR via another allosteric site on the receptor. Its full mechanism of action is not well-understood. 

Elimination of ketamine is hepatic. Primary metabolic pathway involves hepatic N- demethylation via the cytochrome P450 system to form norketamine; this metabolite is subsequently hydroxylated and conjugated to water soluble compounds. 

The effects when insufflated start within minutes, lasting up to 1-2 hours. 

Substance and dosage: 

Powder or liquid. 

Recreationally usually insufflated. Median user dose is 15-50mg. 

Ketamine has a wide variety of medical uses, primarily as an anaesthetic for pain relieve and narcose. Recently, ketamine has been tested as an rapid-acting antidepressant. 

Unlike conventional narcose agents, ketamine does not cause hypotension and does not decrease the respiratory response to hypercapnia and relaxes bronchial smooth muscle. Respiratory failure may occur in higher doses. Due to its relative safety it has widely been used as a field anaesthetic in military operations and as a narcotic agent in children. 

Overdosage: 

Overdose symptoms may include severe confusion, chest pain and irregular heart rate, paralysis, violence or terrors possibly related to hallucinations, seizures, extreme sedation or even loss of consciousness or coma, and heightened blood pressure.

Ketamine overdose can be fatal, although death from ketamine poisoning alone is rare. Since paralysis is a side effect of ketamine use, if individuals start vomiting, they may be then choke on their vomit. Accidents and injuries related to the dissociative effects may also result in injuries and life-threatening consequences

The World Health Organization (WHO) published research that indicates ketamine, when injected, may be lethal at doses above around 11 mg/kg of body weight. 

There are no current medications specifically approved to treat ketamine addiction or reverse an overdose. Treatment consists of supportive care. Seizures may be treated with benzodiazepines.