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S(+)-ketamine: Current trends in emergency and intensive care medicine

S(+)-ketamine, the pure dextrorotatory enantiomer of ketamine has been available for clinical use in analgesia and anesthesia for more than 25 years. The main effects are mediated by non-competitive inhibition of the N-methyl-D-aspartate (NMDA) receptor but S(+)-ketamine also interacts with opioid r...

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Autores principales: Trimmel, Helmut, Helbok, Raimund, Staudinger, Thomas, Jaksch, Wolfgang, Messerer, Brigitte, Schöchl, Herbert, Likar, Rudolf
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Vienna 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6061669/
https://www.ncbi.nlm.nih.gov/pubmed/29322377
http://dx.doi.org/10.1007/s00508-017-1299-3
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author Trimmel, Helmut
Helbok, Raimund
Staudinger, Thomas
Jaksch, Wolfgang
Messerer, Brigitte
Schöchl, Herbert
Likar, Rudolf
author_facet Trimmel, Helmut
Helbok, Raimund
Staudinger, Thomas
Jaksch, Wolfgang
Messerer, Brigitte
Schöchl, Herbert
Likar, Rudolf
author_sort Trimmel, Helmut
collection PubMed
description S(+)-ketamine, the pure dextrorotatory enantiomer of ketamine has been available for clinical use in analgesia and anesthesia for more than 25 years. The main effects are mediated by non-competitive inhibition of the N-methyl-D-aspartate (NMDA) receptor but S(+)-ketamine also interacts with opioid receptors, monoamine receptors, adenosine receptors and other purinergic receptors. Effects on α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptors, metabotropic glutamate receptors (mGluR) and L‑type calcium chanels have also been described. S(+)-ketamine stimulates the sympathetic nerve system, making it an ideal drug for analgosedation or induction of anesthesia in instable patients. In addition, the neuroprotective properties, bronchodilatory, antihyperalgesic or antiepileptic effects provide interesting therapeutic options. In this article we discuss the numerous effects of S(+)-ketamine under pharmacological and clinical aspects especially for typical indications in emergency medicine as well as intensive care.
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spelling pubmed-60616692018-08-09 S(+)-ketamine: Current trends in emergency and intensive care medicine Trimmel, Helmut Helbok, Raimund Staudinger, Thomas Jaksch, Wolfgang Messerer, Brigitte Schöchl, Herbert Likar, Rudolf Wien Klin Wochenschr Review Article S(+)-ketamine, the pure dextrorotatory enantiomer of ketamine has been available for clinical use in analgesia and anesthesia for more than 25 years. The main effects are mediated by non-competitive inhibition of the N-methyl-D-aspartate (NMDA) receptor but S(+)-ketamine also interacts with opioid receptors, monoamine receptors, adenosine receptors and other purinergic receptors. Effects on α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptors, metabotropic glutamate receptors (mGluR) and L‑type calcium chanels have also been described. S(+)-ketamine stimulates the sympathetic nerve system, making it an ideal drug for analgosedation or induction of anesthesia in instable patients. In addition, the neuroprotective properties, bronchodilatory, antihyperalgesic or antiepileptic effects provide interesting therapeutic options. In this article we discuss the numerous effects of S(+)-ketamine under pharmacological and clinical aspects especially for typical indications in emergency medicine as well as intensive care. Springer Vienna 2018-01-10 2018 /pmc/articles/PMC6061669/ /pubmed/29322377 http://dx.doi.org/10.1007/s00508-017-1299-3 Text en © The Author(s) 2017, Corrected publication June 2018 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Review Article
Trimmel, Helmut
Helbok, Raimund
Staudinger, Thomas
Jaksch, Wolfgang
Messerer, Brigitte
Schöchl, Herbert
Likar, Rudolf
S(+)-ketamine: Current trends in emergency and intensive care medicine
title S(+)-ketamine: Current trends in emergency and intensive care medicine
title_full S(+)-ketamine: Current trends in emergency and intensive care medicine
title_fullStr S(+)-ketamine: Current trends in emergency and intensive care medicine
title_full_unstemmed S(+)-ketamine: Current trends in emergency and intensive care medicine
title_short S(+)-ketamine: Current trends in emergency and intensive care medicine
title_sort s(+)-ketamine: current trends in emergency and intensive care medicine
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6061669/
https://www.ncbi.nlm.nih.gov/pubmed/29322377
http://dx.doi.org/10.1007/s00508-017-1299-3
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