In subanesthetic concentrations ketamine has analgesic and sedative properties. It is not suitable for monotherapy because of its excitatory and hallucinogenic side-effects. However, these can be avoided if ketamine is administered in combination with benzodiazepines or propofol. Ketamine acts as an antagonist at the W-methyl-D-aspartate (NMDA) receptor, thus preventing and counteracting neurophysiological mechanisms after prolonged nociceptive stimulation (e.g. wind-up) resulting in hyperexcitatory nociceptive spinal neurons. This beneficial effect of ketamine is of clinical relevance if tolerance has developed after prolonged opioid administration. Ketamine doses of 1 to 2 mg/kg/h restore analgesia and simultaneously allow significant reduction of the opioid dosages. Ketamine offers advantages in hemodynamically unstable patients (e.g. septic shock). Because of its catecholamine-releasing properties, exogenous catecholamaines may be significantly reduced in these patients. However, these actions, which may also result in tachycardia and hypertension, should be considered carefully in patients with coronary heart disease. In patients with significant constipation due to high opioid dosage, ketamine should be seriously considered as an alternative analgesic.

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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