Currently, there is no specific, direct-acting antagonist to counteract the effects of ketamine. Management of adverse effects focuses on supportive care. This involves ensuring adequate ventilation, maintaining cardiovascular stability, and managing any emergent psychological disturbances. The primary objective is to address the symptoms presented by the individual rather than reversing the drug’s action directly.
Supportive care’s importance stems from ketamine’s complex pharmacology. While ketamine primarily acts as an NMDA receptor antagonist, it also interacts with opioid receptors, monoaminergic transporters, and voltage-sensitive calcium channels. This multifaceted mechanism of action makes the development of a single, universally effective reversal agent challenging. Historically, clinicians have relied on careful monitoring and targeted interventions to mitigate undesirable effects.
