Ketamine and its action. Ketamine is a psychoactive drug

General Description of Ketamine

Hallucinogenic narcotic drug synthetic origin.

Chemical Name: 2-(methylamino)-2-(2-chlorophenyl)-cyclohexane hydrochloride.
Chemical formula: C13H16CINO-HCL

Synonyms and slang names for ketamine:

English: Cat Tranquilizer, Ketamine, Ket, K, Special K, Vitamin K
Russians: Calypsol, Vetalar, Ketalar, Ketanest, Ketajekt, Ketagest, Ketazet

White crystalline powder with a slight characteristic odor, easily soluble in alcohol and water.
released in the following dosage forms: 5% solution in 2 and 10 ml ampoules (Solutio Ketamini hydrochloridi), 10% solution in 10 ml vials (Calypsol Gedeon-Richter), 25% solution in 10 ml vials (Bioketan).

It is widely used for surgical anesthesia, and has become especially widespread in veterinary practice. Ketamine hydrochloride - a general anesthetic, which blocks nerve endings, and at the same time does not act depressingly on breathing and blood circulation.
Anesthetic response of the body to ketamine was named dissociative, because the consciousness at the same time, as it were, is separated - dissociates- from the body. Since ketamine does not suppress respiratory and swallowing reflexes, this circumstance significantly reduces the risks side effects- for example, the risk of choking on one's own saliva. In this regard, the drug is widely used as a means for anesthesia in surgical operations. Especially often it is used in emergency surgery - that is, in cases where there is not enough time to study the patient's response to a particular drug, and the risk of side effects increases significantly.

History of ketamine

In 1962 ketamine first synthesized by American researcher Calvin Stevens (K. Stevens), the original name of the drug is "CI-581".
In 1965, Professor Edward Domino gives ketamine description as a powerful drug. Since the mid-1970s, interest in the drug has been growing rapidly around the world. In 1978, two books were published at once, which had a significant impact on the popularity of ketamine.
These are "Journey Into the Bright World" by Marcia Moore and Howard Alltounian, and "The Scientist" by John Lily. Both books describe the personal experiences of the authors when using the drug as a drug.
Between 1987 and 2000, there were 12 deaths in the United States and Europe related to ketamine overdose. In Russia ketamine has become widespread as a drug since the early 1990s, when a lot of so-called psychedelic literature, and other known hallucinogens - such as LSD - were virtually non-existent on the illegal market.

The action of ketamine

outside medical use of ketamine commonly used as a psychedelic drug. The action of the drug can be divided into three stages:
First stage - Entrance- begins almost immediately after taking the drug, and is characterized by a feeling of "stretching" and "twisting" the body.
The second stage is called Failure. At this stage, consciousness "breaks away" from the body and the person almost completely falls out of reality. At the same time, many note an amazing sobriety of thinking. Experiences at this moment different people vary quite a lot, but many include in their descriptions alternative spaces and universes, future prediction, machines and mechanisms of unknown purpose and feeling boundless loneliness. Sometimes drug use leads to the so-called " bad tripu"- a state in which the patient experiences strong negative experiences.
Third stage - Exit. At this stage, there is a gradual return of consciousness to reality. It is characterized by a feeling called in slang rubber boys- when the muscles are not yet fully controlled by consciousness. As a result, the person acts like a "rubber". It is best to lie or sit in this state.

Harm and dependence on ketamine

Ketamine overdose may cause nausea and vomiting. With regular use of the drug, tolerance quickly develops.
Physical dependence on the drug is formed in 4-7 months of systematic use. withdrawal syndrome in case of refusal of the drug in this case has the following symptoms: on the first - second day there are violations of the gastrointestinal tract, persistent insomnia, a feeling of emptiness and loss of strength, as well as pain in the muscles of the arms and back.
The acute phase of withdrawal lasts up to ten days. At the end of the acute stage, a period of moderately pronounced apathetic state begins.

Diagnosis and treatment of ketamine addiction

Ketamine use can cause hypertonicity and involuntary movements, as well as various kinds hallucinations. These symptoms are removed with the help of tranquilizers or droperidol.

Legislation

Referred to "List II of narcotic drugs and psychotropic substances, the circulation of which in the Russian Federation is limited and in respect of which control measures are established in accordance with the legislation of the Russian Federation and international treaties of the Russian Federation" According to the pharmacopoeial classification, it is referred to "List A", and falls under definition potent substances covered by Art. 226 of the Criminal Code, which prohibits them " sale and other actions for the purpose of sale».

1) Are there other names for Ketamine?

Yes. Ketamine is produced by many pharmaceutical companies and has many synonyms. Some of them are: Kalipsol, Kalipsol (Hungary), Ketaject (USA), Ketalar (UK), Ketanest, Ketaset, Ketolar, Vetalar. Slang names in the West include K, Ket, Ketamine, Special K, "Vitamin K". Do not confuse ketamine with real vitamin K (blood clotting factor) - you can only get thrombosis from it.

2) What is Ketamine called by chemists?

Systematic name: 2-(methylamino)-2-(2-chlorophenyl)-cyclohexane hydrochloride. In English literature, it is sometimes also called 2-(2-Chlorophenyl1)-(methylamino)-cyclohexanone hydrochloride. These names are equivalent.

3) What is the status of Ketamine in Russian legislation?

Ketamine is not on the official "List of Drugs" (according to at least, was not listed in 1991; I can't find later listings). According to the pharmacopoeial classification, it belongs to "List A", which means that medical institutions must comply special precautions during its storage and keep a special account. "List A" usually refers to narcotic or poisonous drugs, apparently, ketamine is assigned to the latter. It is also possible that it falls under the definition of a “potent” substance, in which case Art. 226 of the Criminal Code of Russia, which prohibits the "sale and other actions for the purpose of sale" of such substances.

4) How is it used?

Catamine is used primarily for surgical anesthesia (narcosis), including in veterinary practice. Anesthesia with the introduction of Ketamine has been called "dissociative", which means, in particular, that the consciousness during it "separates" (or "dissociates") from the body. The main advantage of Ketamine over other anesthesia drugs is that it does not suppress the laryngeal and pharyngeal reflexes (so you do not risk choking on your own saliva during the operation). In addition, Ketamine depresses breathing much less than other general anesthetics, and it even stimulates the heartbeat. In this regard, Ketamine is especially useful in emergency surgery (for example, with natural disasters etc.) when dangerous side effects are especially undesirable. Of course, the consciousness, separating from the body, can travel to other dimensions, which allows you to use Calypsol for psychedelic purposes.

5) What is "psychedelic"?

In a literal translation from Greek, "psychedelic" - enlightening the soul. This name is most often used in relation to certain substances, as well as a certain kind of music, which allows you to experience unusual experiences, go beyond the ordinary, get closer to God, and so on. Psychedelic drugs do not necessarily direct a person to Good or Good, but provide an opportunity for this. They can be used for self-discovery, energy recovery, or simply for a change of environment and relaxation (in the West, the name "recreational chemicals" has become widespread, emphasizing precisely this latest use of psychedelic drugs. Anyway, earthly authorities do not want to allow their subjects to go beyond their borders. influence, so psychedelic drugs (and, in countries with more outspoken regimes, psychedelic music and other psychedelic arts) are strictly banned, using the ridiculous argument that the bans are "for the own good" of the citizens.

6) How did Ketamine come about?

"Is this the same Philosopher's Stone?" asked the editor of the journal Anesthesia (Anaesthesia 26(2) 1971). The search for a safe general anesthetic led pharmacologists in 1963 to phencyclidines (first CI-395 aka PCP aka Sernyl, which was later called Angel "s Dust -" Angel dust”, and then CI-400 aka cyclohexamine). Although they gave adequate anesthesia, strong psychotic reactions were noted in patients. Further research led to Ketamine, first introduced at Michigan State University in 1965. Ketamine at therapeutic doses did not cause psychotic reactions. It was mass-produced by Parke-Davis (CI-581, Ketalar) as a safe general anesthetic with rapid onset and rapid recovery, and it was widely used as early as Vietnam. Of course, returning from the illusory K-space to hospital beds, patients told incredible stories ...

How are you feeling, Mr. Brown?

Okay, doc. I floated under the ceiling and looked at my body ...

I died and went to Heaven. I saw God and Angels, it was wonderful!

When the UFO landed, these little aliens took me and we flew together.

Everything around was red. Then I realized that I had become an erythrocyte ...

I remembered mine past life. I was a mathematician in ancient Egypt.

Hey guy! What kind of fake acid was given to me?

What the hell did you give my boy, Doctor?

Physicians are not strong in metaphysics, so they labeled these strange phenomena as " acute reactions and Ketamine began to get a very bad reputation. How can we control these damn hallucinations? the doctors asked themselves. Of course, the answer was obvious - you need to treat the patient like a person, not like a machine. Explain to him that he will go on a journey. Tell me what to expect there. Tell me how you can deal with his problems. When he returns, leave him in a quiet place to recover, and so on. Big study showed that undesirable consequences can be effectively avoided in this way. This study was widely ignored, and now patients are simply pumped up to their ears with powerful benzodiazepines so that they cannot remember what happened to them.

Let's add one interesting feature Ketamine: They can be used to solder women to seduce. It should be added drop by drop to any low-alcohol effervescent drinks: champagne, beer, brandy-cola. The dose is established empirically, but do not overfill, otherwise the drink will have a disgusting taste and smell.

7) Why did Ketamine start being used for psychedelic purposes?

And this is a completely different story. While the mind-altering effects of ketamine make it one of the ideal psychedelics, its lack of euphoria (bliss) has not made it a popular drug. However, psycho-chemists have long used Ketamine to study altered states of consciousness. Jay Stevens, in his book The Storming Heaven: LSD and the American Dream, writes that research into psychedelic drugs has not stopped in the States since the 1960s. An existing network of researchers there, whom Stevens calls the "psycho-chemical frontier," continued to study the effects of psychedelic drugs on the human mind. When laws prohibited the use of certain "tools", they switched to other substances, the use of which was not restricted. By the time Stevens's book was printed (in 1987), members of this network had found or synthesized enough new drugs with strange names to fill a new pharmacopoeia. For example, Adam, Eve, Venus, Intellex and 2CB were actively used. Stevens asked many members of this secret society what they considered the "best" drug, and the two most commonly reported drugs were MDMA (Ecstasy, X) and Ketamine.

But in the wide distribution of Ketamine, the main role was played by politics - the prohibitive and grasping policy of governments in the field of psychochemistry. If the police, for example, manage to intercept a significant proportion of the weed that enters the market, some people begin to use synthetic drugs for psychedelic purposes. When the supply of imported heroin in Scotland fell sharply, people began to use pharmaceutical preparations, which undoubtedly cause much more damage to health than heroin could, under any conditions, cause. By the time MDMA was banned, hundreds of thousands of people had discovered this wonderful drug and with it completely switched off from their problems on the weekends. The drastic decline in access to MDMA has logically led to another relatively legal drug taking its place. Of course, many were disappointed - after all, Ketamine, in essence, a medicine for one, and Ecstasy had very valuable social qualities.

One such person, in his thirties with extensive experience in illegal drugs, took some Ketamine, thinking it was Ecstasy, but it turned out to be something completely different. He says: “It didn't feel like MDMA at all. When I took one pill and closed my eyes, I saw pale colors and shapes, but no euphoria, no excitement, no clarity of thought, no desire to dance. A few days later I took three or four at the same time to see what would happen. It was like entering another dimension. All of a sudden you are no longer here. You cannot move, you cannot think - all you can do is watch. It is only when you get out of the influence of Ketamine that you begin to realize where you are and where you have been. Then the world turns the other way and you get some idea of ​​the relationship between different parallel universes... As the effects of Ketamine began to wear off, I became more aware of myself inside my body. I felt like a Robocop or a Terminator, some kind of cyborg. I felt that my face was made of a mass of needles or edges or electrical impulses. The slightest movement was accompanied by an intense sensation of mechanical activity in my body. It wasn't pleasant or unpleasant, it just was."

But, for better or worse, due to the circumstances, many thousands of people got acquainted with Ketamine, and some of them found it very useful in terms of spiritual development.

8) How is Ketamine used in medicine?

Main medical application Ketamine is used as an anesthetic. By the way, the basic information about him is easiest to get from a medical reference book. It says that Ketamine is a white crystalline powder with a slight characteristic odor, easily soluble in water (1:5) and alcohol (pH of aqueous solutions is rather acidic - 3.5–4.5). lung activity. The action of the drug is mainly associated with a depressing effect on the associative zone of the cortex and subcortical formations of the thalamus. Cumulation with repeated administration is not observed.

The minimum effective anesthetic dose of Ketamine for intravenous administration is 0.5 mg per kilogram of body weight, while consciousness turns off after 1-2 minutes and the effect lasts about two minutes. At a dose of 1 mg / kg, anesthesia lasts about 6 minutes, and at a dose of 2 mg / kg - about 10-15 minutes. With intramuscular injection, the effect occurs more slowly, but is longer (with the introduction of 6-8 mg / kg, the effect develops after 6-10 minutes and lasts up to 30-40 minutes).

Enter Ketamine intravenously (stream or drip) and intramuscularly. Adults are given 2–3 mg/kg IV or 4–8 mg/kg IM. To maintain anesthesia, injections are repeated (0.5–1 mg/kg IV or 3 mg/kg IM).

Ketamine causes an increase in blood pressure (by 20–30%) and increases heart rate with an increase in cardiac output; peripheral vascular resistance decreases. Stimulation of cardiac activity can be reduced by the use of diazepam (sibazon). As a rule, Ketamine does not cause bronchospasm and laryngospasm, does not inhibit the reflexes of the upper respiratory tract. Nausea and vomiting usually do not occur. The use of Ketamine may be accompanied by involuntary movements, hypertonicity, hallucinatory phenomena. These effects are prevented or removed by the use of tranquilizers or droperidol.

With the on / in the introduction of Ketamine, pain and redness along the vein are sometimes possible; upon awakening, psychomotor agitation and a relatively long disorientation are possible.

*Attention! Ketamine is contraindicated in severe violations cerebral circulation or in the presence of such disorders in history, with severe hypertension, eclampsia, with severe decompensation of blood circulation, epilepsy and other diseases accompanied by convulsive readiness. Do not mix ketamine solutions with barbiturates (they precipitate).

Release form: 5% solution in ampoules of 2 and 10 ml, in a package of 10 ampoules; 10% solution in vials of 10 ml. Storage: List A, protected from light.

9) Is it necessary to inject?

It is easy to see that in medicine Ketamine is used exclusively in the form of injections - intravenous or intramuscular. This is due to the greater efficiency and speed of onset of effects with this method of administration. On the other hand, in the absence of the necessary experience and appropriate conditions, it is better to avoid injections, because the list of possible complications includes embolism and abscesses (if the injection technique is violated), gas gangrene, tetanus and sepsis (if sterility is violated), AIDS and hepatitis B (when used together syringes) and much, much more. In addition to all this, some pious individuals may be frightened by seeing injection marks.

In addition to injections, Ketamine can be taken orally, although it tastes disgusting. It is best to shove the solution on a spoon deep into the throat and drink immediately (preferably orange juice). With this method of application, the effect occurs somewhat more slowly, but not much - after 15-30 minutes, depending on the dose, which should be about twice as high. intramuscular dose to achieve the same effect, and last longer - up to 4-5 hours at the maximum dosage.

Another interesting method of using Ketamine is intranasal. It is best to carefully evaporate the solution (unless you have Ketamine in crystalline form), grind the crystals very finely with a razor blade, place the powder in a thin line on a mirror and suck it up your nose with a small tube. In this case, the effect occurs very quickly, after 1-5 minutes and does not last long - up to half an hour, with residual effects not more than one hour and is very different from the effect of oral administration of the corresponding dose. Personally, I don't like this difference - more of a stunner than a truly psychedelic effect, I think. You can probably just drop the solution into your nose, but it's pretty hard not to swallow some of it, so it's not a "clean" experiment.

10) What is the usual dose of Ketamine?

The dosage of Ketamine depends on the method of use, the desired effect and its duration. It is best to start with low doses (0.2-0.4 mg/kg) and gradually increase the dose until you achieve the optimal effect for you. Doses should be increased to at least 100–150 mg to really experience the specific effects of Ketamine. For most routes of administration (except intranasal), the potency of Ketamine is directly proportional to the dose (linear relationship). There are two important points in this line. Upon reaching the first of them, you will completely lose touch with the outside world (that is, your normal feelings will be completely turned off); this point is not recommended for beginners. As you continue to increase the dose, you will reach a second point where you will completely lose consciousness. This is not interesting at all and is not recommended to anyone.

It must be borne in mind that with regular use, tolerance (relative insensitivity) develops, requiring an increase in doses. After a pause of several weeks, the sensitivity is restored. “Catching up”, that is, administering repeated doses, is not recommended (with the exception of the intranasal method, in which the duration of the effect may be insufficient).

Ketamine is a drug that has been used in medicine since the early 1960s. The drug was the discovery new era general anesthesia for short-term and emergency surgical, gynecological interventions, as well as to facilitate painful methods instrumental diagnostics. Especially in cases that have restrictions on the use and drugs. This medicine also had a positive effect in cases of bronchospasm. Due to concomitant psychedelic effects, in the environment dependent people widespread abuse of ketamine.

The drug has analogues, which are best known under the names - calypsol, ketanest, ketalar.

General information

When used in many patients, the drug causes excitement and an influx of hallucinatory visions. These side effects are especially pronounced in patients with drug and alcohol addiction.

Among drug addicts, ketamine gained fame thanks to the books of M. Moore and G. Alltounian, who colorfully described the effect of the drug based on their own experience.

In practice, this medicine is used in the theaters of military operations of local wars, as well as in veterinary medicine.

In the USSR, this medication has appeared since the 80s of the last century. And since the 90s, it begins to actively spread as a narcotic psychedelic drug. In 1998, it was officially classified as a drug in Russia.

The use of ketamine was accompanied by a number of high-profile criminal scandals.

Note: This drug received particular popularity among the youth due to its “bright” experiences against the backdrop of “heavy” and expensive.

How does ketamine affect humans?

The effects of the drug are based on its selective inhibition of certain sections of the cerebral cortex and thalamus. At the same time, it delays the speed of the functions of the limbic system and the hippocampus (causing a perversion of awareness of sensations). These processes lead to disorders of connections between departments, especially the midbrain and thalamus. In medicine, this condition is called dissociative anesthesia (in which a pronounced change in human consciousness occurs). Ketamine has an effect on opioid receptors, causing analgesia and related psychoactive effects. By acting on cholinergic receptors, the substance contributes to the expansion of the bronchi and the development of a specific delirious state.

Doses, dependence and abuse of ketamine

Among drug addicts using this substance, the most popular intramuscular method of administration. It is considered particularly effective due to the "optimal" combination of dose and duration of the narcotic effect. Intravenous use causes a brighter euphoria, but which lasts much less (up to 30-60 minutes) than with intramuscular injection (several hours).

More rare are intranasal (inhalation) and oral (ingestion) methods of anesthesia.

Initial doses are on average 0.5-0.6 ml of a 5% solution of ketamine. Gradually developing tolerance (resistance) forces the patient to increase the dose several times.

As noted above, the main consumers of ketamine are teenagers. The initial use of the drug occurs in a group. The main motive is to imitate those who have already experienced its effects. The group form of drug addiction is the initial period of addiction formation. It is in them that a combination of drugs and effects often occurs.

Only those who have experienced a dangerous condition for life or health leave the group.

For those who remain, being in a micro-collective becomes the only stimulus expected in life. Without a familiar environment, and without a drug, a teenager begins to experience boredom, mental discomfort, and emotional instability. Parents, unfortunately, notice the change in their children's behavior too late due to the fact that the effect of ketamine has time to wear off within a few hours. A boy or girl gets home already in a normal (conditionally) state.

note: since the drug requires financial resources, teenagers begin to steal money from their parents, and in other places.

If at this moment the group is caught on the facts of drug addiction and theft, the leader is identified and isolated, then this communication may stop, as well as drug use.

For those who continue to take psycho active substance, gradually develops and strengthens mental and physical dependence. The previous doses no longer give an effect, anesthesia passes to a systematic level. Teenagers begin to skip classes, study, lose interest in ordinary life. Their attention is occupied by only one desire - taking a drug.

Often the whole group switches to harder drugs. In this case, the composition of young drug addicts is reduced to a few people with an already pronounced degree of addiction.

Manifestation of an intoxicating effect in the abuse of ketamine

Ketamine intoxication is divided into three to four phases:

1. The effect of the drug appears 5-10 minutes after it enters the body.(consider the most common - intramuscular method of administration). The duration of phase 1 is 2-3 minutes. The patient experiences: relaxation (pronounced relaxation), sedation, light and pleasant, peculiar taste sensations.
2. The duration of this phase is limited to 2-4 hours. In this state, the patient feels a physical and mental uplift, the mood improves. Lightness, airiness, flexibility, some derealization appear in the body, which drug addicts call "weightlessness". It seems to patients that their own body is changing in size and volume.
3. This phase develops when a large dose of ketamine is taken.. Intoxication of the 2nd phase gradually disappears and is replaced by irritability, weakness. Patients look tired, sluggishly answer questions, they have inhibited all reactions. There is a feeling of absence own body(dimorphophobia). Mental derealization, suspicion, ideas of persecution and fear develop. These manifestations are accompanied by illusory-hallucinatory experiences, seeing pictures, hearing music. On examination, the patients are pale, the pupils are markedly dilated, coordination is disturbed, the heart rate is increased by 20-30 beats, blood pressure is persistently increased.
4. The final phase lasts 1-2 hours, and is characterized by a sharply reduced sensitivity which is sometimes absent altogether. Appears, pronounced weakness, a peak of coordination disorders. Gradually, all phenomena disappear.

Note! With regular intake, the first phase is practically absent, or felt for a few seconds. The manifestations of the second and third phases merge together.

After a few months, patients learn the techniques of drug self-regulation. They eliminate sensations of fears, direct hallucinations, alleviating or completely eliminating negative feelings from ketamine.

In sober moments, a constant form of absent-mindedness, confusion develops, attention and memory functions suffer. Thinking loses logic, depth. Patients are morally lowered. Outwardly, they lose weight, pathological rashes appear on rough skin. gives impetus to development. Patients suffer from tachyarrhythmias (expressed palpitations).

note: against the background of deprivation of ketamine, drug addicts clearly show withdrawal symptoms.

Withdrawal syndrome (withdrawal)

The absence of a psychoactive substance causes patients to:

• , fears;
• e, trembling in the body and sweating (vegetative disorders);
• condition general malaise and discomfort;
• drawing and aching, which greatly depresses the patient.

Addicts are looking for the possibility of drug addiction in every possible way, begging and seeking funds for drugs under any pretext. Withdrawal syndrome lasts from a day to two weeks.

Treating Ketamine Abuse

At the initial stages of taking a narcotic substance, special treatment is not required. For the purpose of clarification possible consequences handled by experienced teachers and psychologists. In some cases, you may need individual sessions with a teenager and family psychotherapy.

In more advanced cases drug intervention is required. Ambulatory treatment implies drug therapy for existing mental disorders (using,). Cardiac disorders (increased heart rate and high blood pressure) are eliminated by individual selection of the required medicines.

note: with unfavorable social conditions in an environment, a pathological mental background, inpatient therapy is required.

The clinic conducts a thorough physical examination and, most importantly, a psychological examination and correction.

The hospital has more wide opportunities in terms of the use of rational and group psychotherapy. Behavioral correction, aesthetic therapy, healing sessions of hypnosis allow you to achieve good effect. Treatment in these cases should not be rushed in order to limit the patient's return to the usual environment as much as possible.

The best solution would be to continue recovery in a rehabilitation center with a subsequent change in place of residence, work and the surrounding society.

AT severe cases ketamine abuse requires massive drug therapy with detoxification, the use of neuroleptics (for psychotic disorders). At the exit from acute manifestations, restorative treatment is required.

Prognosis for abuse of ketamine

The outcome of dependence is determined by the patient's age, experience, environment and the quality of psycho-correction and treatment. Timely therapy allows you to achieve a good remission or even complete cure, subject to lifelong abstinence from the drug.

It should be remembered that if the dependence period lasts more than 1 year, patients develop a serious psycho-organic syndrome that is difficult to reverse. If the experience of anesthesia exceeds 3-4 years, then patients develop severe dementia, degradation with desocialization, moral emptiness, rudeness, indifference to themselves, others, loss of life purpose

Ketamine is recognized in the Russian Federation narcotic substance, belongs to the list A. The list includes drugs, the sale of which is controlled by the state. The medicine is released only on prescription, written out on a special form designed to record the movement of narcotic drugs.

Ketamine drug

Ketamine is a synthetic narcotic psychoactive drug, a hallucinogen. It has an analgesic, hypnotic effect, does not have the ability to accumulate in the body.

It is a white crystalline powder, soluble in alcohol, water, fats. Belongs to a group of funds general anesthesia.

Application area

It is used in surgery for induction and basic anesthesia, especially in emergency surgery due to the preservation of the ability to self-ventilate the lungs.

In veterinary practice in the Russian Federation, the use of the drug is possible if the clinic obtains a special license. Ketamine analogues - Ketalar, Calypsol, Ketanest. Ketamine goes on sale in the form of ampoules, vials with clear liquid, white color tablets or powder.

Due to the ability to dissolve in fats, it easily penetrates the blood-brain barrier of the brain.

Forms of use

It is used by drug addicts mainly in the form of snuff. This form of the drug is considered less dangerous, requiring small doses of the psychedelic to be effective.

The effect is more pronounced and represents great danger taking drugs in pills. The tablets are sold under the guise of Ecstasy with a distinctive logo. The introduction of ketamine intramuscularly is accompanied by a brighter onset and severe pain at the injection site.

Even more dangerous is the introduction of ketamine into a vein. The change in consciousness sometimes occurs faster than the person has time to remove the needle from the vein. With intravenous administration, the risk of getting a lethal dose increases.

Compound

Ampoules, vials for non-inhalation anesthesia contain ketamine hydrochloride as an active substance, as well as auxiliary components.

Produced in ampoules with a capacity of 2, 5, 10 ml, bottles of 5 ml. 1 ml of solution contains 57.6 mg of ketamine hydrochloride, which is equivalent to 50 mg of ketamine.

Ketamine is an amino acid antagonist excitatory, an NMDA receptor blocker. It is similar in structure and properties to phencyclidine.

The half-life is 2-3 hours. But the drug is found in the blood during the study for another week after use, and in the case of chronic drug addiction, even after 20 days.

Mechanism of action

Ketamine disrupts the work of the brain like dissociative anesthesia, acting on the associative zone of the cerebral cortex and thalamus.

The brain under the influence of ketamine for a short time loses the ability to analyze incoming sensory information, keeping it in full respiratory reflexes, in part - muscle activity. In particular, the cough, pharyngeal, and laryngeal reflexes are preserved.

With anesthesia with ketamine, there is no complete blackout. The patient appears to be fully conscious. He can make swallowing movements, his muscles are able to contract, his eyes are open.

Indications

The drug is used for intravenous anesthesia, it is indicated:

• during the medical manipulations that do not require muscle fixation;
• transportation of patients with burns;
• pain, traumatic shock;
• significant blood loss.

Such use of Ketamine is possible due to the fact that the properties of the drug include the ability to maintain the ability to self-ventilate the lungs in the absence of oppression of cardiac activity.

Ketamine is used by dentists, otolaryngologists, gynecologists for minor surgical interventions that require fast-acting anesthesia for a short time (up to 3 hours).

Ketamine is contraindicated in violation cerebral circulation, epilepsy, alcoholism, high blood pressure. It is not used for heart failure, angina pectoris, operations on the pharynx.

Effect

The psychedelic effect of "separation from the body", "expansion of consciousness" is explained by a violation of the connection between the centers of the brain that analyze signals from the sense organs and the sensory analyzers themselves.

The action of the drug when administered intramuscularly begins almost immediately. When taken in the form of tablets, "Nastya", "ket", "vitamin K", as ketamine is called in slang, penetrates the brain and begins to act 15 minutes after use.

Stages of intoxication

First, the legs and arms go numb, the person loses the desire to actively move, there is a desire to lie down. He is dizzy, consciousness is distorted. A person has no idea what his name is, who he is, what size.

Lack of euphoria when using the drug, fortunately, did not make it popular, but still, it is quite common. Excitation is absent, there is no desire to run, sing or dance with delight. No desire to communicate.

Consciousness seems to move into a parallel world, a person can observe himself from the side without feeling his body. A person can feel like an object that moves along electrical wires or communication lines, travel in the future or past.

Good and bad trip

In most descriptions of the ketamine trip, it slips that the scenario of these fantastic visions is associated with activities, sensations that preceded drug intoxication.

If before taking the drug a person was engaged in painting, then one way or another the imagination will beat this topic. And what is perceived as an “expansion” of consciousness is just walking in a circle, repeating in different variations what the brain has recently received and stored in memory.

A ketamine trip is similar to the action of opium, alcohol, nitric oxide at the same time, lasts up to 1.5 hours. At the same time, as an answer to the question “how long the drug works”, you can safely answer - a day, because that is how long the consequences of taking a psychedelic are observed.

Ketamine enhances the state in which the drug addict was at the time of drug use. If he was in a good mood, then the trip will get optimistic. But if some gloomy, sad thoughts at the time of taking the pill or injection cared for the patient, then he will get a bad trip filled with nightmares.

After about a month of drug use, both good and bad trips disappear. By this time, the drug addict is constantly experiencing anxiety, panic moods.

The source of concern may be the ketamine metabolite norketamine, which has a sedative effect. And when using ketamine, the usual calm state simply returns.

Exit from intoxication

Getting out of ketamine intoxication begins with awareness of yourself inside the body. The return is accompanied by unpleasant discomfort in the muscles, tingling, strange mechanistic sensations at the slightest movement.

The ability to focus on objects gradually returns, and even manages to remember their names. Coordination does not immediately return. The movements remain “rubber” for a long time, which is noticeable to others and does not feel like a drug addict at all.

There is usually no desire to take ketamine again after the first time, physical addiction is not formed. But psychological dependence develops quickly and forces you to take the drug again.

And after a few months of addiction, all these vivid and interesting impressions that the patient experiences when intoxicated, he is no longer able to remember and describe the next day due to weakening of memory and increasing degradation of the personality.

Development of addiction

Ketamine is not believed to cause strong dependence, and getting rid of it is not difficult. However, physical dependence exists, if only because the addict has to increase the dosage of the drug. Formation of physical dependence lasts 4-7 months.

A sign of physical dependence can be a quick relief from discomfort, lethargy when taking even a small dose of medication.

The addict does not experience physical pain when the drug is withdrawn, but the withdrawal syndrome exists, manifested by symptoms:

• muscle pain;
• depression
• sleep disturbance, digestion.

The discomfort does not last long, and after 7-10 days it completely disappears.

Mental dependence on taking the drug is formed quickly and manifests itself clearly. A drug addict develops a state when the drug is required so much that the patient quits all his affairs and looks for this source of bliss.

Signs and symptoms of use

Ketamine is mainly administered intramuscularly (in the buttocks), it is impossible to identify a ketamine addict by veins. Into a vein due to short action drug, the need for a partner for injection, high risk overdoses of ketamine are rarely administered.

Longtime ketamine addicts may have blood stains on their clothes from injections of the drug right through them.

Common symptoms for ketamine users are:

• pupil diameter is not changed, but the look is detached, unblinking.
• movements constrained, poorly coordinated.
• absence of pain;
• slurred speech;
• inability to focus;
• abrupt mood changes, outbursts of irritability.

Side effects

In a large dose, ketamine disrupts the work of the respiratory center, causing shortness of breath, acts on the respiratory muscles, muscles of the tongue, causing spasm, retraction of the tongue into the pharynx, preventing breathing.

When taking the drug in powder form, the effect seems to be negligible, and the person under the influence of the drug leaves home to seek adventure. The lack of connection between the signals coming from the body and the analyzers of the brain leads to an inadequate assessment of the situation.

A person under ketamine can freeze without feeling cold, get burned without feeling the heat from a match, get serious injury without experiencing pain. Intranasal use of ketamine also has delayed side effects.

Do not remain without consequences irritation of the mucous membrane with an analgesic. chronic inflammation mucosa can end very badly - malignant degeneration of tissues, the development of cancer.

Impact on the heart

Ketamine is dose dependent. Large doses The drug depresses the work of the heart, causes nausea, vomiting, difficulty breathing.

Taking small doses of ketamine leads to an increase in the work of the heart muscle (myocardium), which increases pressure in the pulmonary artery.

Acting on the nerve centers of the sympathetic nervous system, the drug:

• increases blood pressure;
• causes heart palpitations;
• increases cardiac output- the volume of blood that the ventricle is able to expel during contraction.

Negatively affects the condition of the heart muscle physical activity when using ketamine. Going to a disco under the influence of ketamine, the drug addict thereby tests the strength of the innervation system of the heart.

Action on the brain

Ketamine increases blood flow in the brain, increases oxygen concentration, increases intracranial pressure, enhances subcortical neuronal activity, manifested by myoclonic movements. Upon awakening, hallucinations, frightening dreams, and prolonged disorientation in space may occur. Excitation, psychosis are possible.

A change in personality indicates a strong psychological dependence on a psychedelic, which is expressed in sleep disturbance, memory, weakening of the intellect, attention disorder. Pretty soon, a person completely changes his social circle, loses his job, his family.

Influence on the digestive organs

Large doses of ketamine cause vomiting, nausea, and salivation. Admirers of this drug go to the world of dreams, attaching a basin nearby so that they do not have to interrupt their flight of fantasy by going to the toilet.

The drug addict usually loses his appetite. He develops exhaustion, emaciation, weight loss.

Effects

• Ketamine causes mental and physical dependence.
• A person during ketamine intoxication does not feel pain.
• The use of ketamine can provoke panic, aggression, personality changes up to schizophrenia.
• When combined with alcohol, ketamine causes life-threatening changes in the heart.

Overdose and poisoning

The intensity of the effects of a psychedelic depends on the dose, especially when the drug is taken in pills or injections. At some stage, the next increase in the dose will not cause a separation of consciousness from the body, but will completely turn off both the body and consciousness, which threatens with a fatal outcome.

The pharmaceutical preparation of ketamine in ampoules has a low concentration and is not capable of causing a narcotic effect in a single dose. By increasing the dose, mixing ketamine with alcohol, a person runs the risk of causing an overdose, provoking vomiting, causing respiratory arrest.

Lethal dose:

• when taken orally - from 50 to 400 mg per 1 kg of weight;
• for intravenous/ intramuscular injection- 77 mg per 1 kg of weight.

Addiction treatment

Ketamine addiction causes a strong mental dependence, which is why the question arises like “how to get off the drug”. Treatment is aimed at overcoming the craving for the drug at the level of consciousness. Panic attacks, fear cannot be eliminated by simply changing ketamine to medicine. “Getting off ketamine” will not work without psychotherapy and psychorehabilitation.

Standard treatment is carried out in three stages:

N.01.A.X.03 Ketamine