Canonical Question

PainPharm – NMDA Antagonists

V5 H6.i Historical V4 K2.i, K4.i.c 1 appearance

Master answer

PROPOFOLKETAMINE
Resp–        Respiratory depression
–        Apnoea
–        Decreased RR, TV, MV, FRC		–        Mild respiratory stimulation
–        Respiratory depression if rapid IV administration
–        Increased secretions
–        Maintenance of pharygo-laryngeal reflexes
>  Laryngospasm
–        Bronchodilation
> Likely Ca channel mediated via R-ketamine isomer
CVS–        Peripheral vasodilation
–        Bradycardia
–        Hypotension		–        Indirect sympathomimetic effects → elevation of MAP
> Due to inhibition of noradrenaline reuptake
–        Direct cardiodepressant effects
CNS–        Sedation
–        Decreased cerebral blood flow		–        Increased cerebral blood flow
–        Increased cerebral O2 consumption
–        Sedation
–        Hallucinations
–        Emergence phenomena
GIT–        Nausea (although usually anti-emetic)–        Nausea
> Due to serotonin reuptake inhibition
Other–        Propofol infusion syndrome
> Rhabdomyolysis
> Metabolic acidosis
> Steatohepatitis
–        Injection site pain
–        Anaphylaxis
–        Leukocytosis		–        Anaphylaxis
–        Increased muscle tone

Exam appearances

ExamExact wordingRelationshipSuccess
2010B Q07 List the adverse properties of Propofol and Ketamine historical_member —