• Mechanism of Action
• Acts as a non-competitive antaagonist at the NMDA receptor
  Reduces presynaptic release of glutamate
  Agonises α and β adrenoceptors
  Agonises opioid σ receptors

Clinical Use

• • Indications
  • Analgesia
  • General anaesthesia for procedures not requiring muscle relaxant
  • Induction of anaesthesia in conjunction with other agents
• • Contraindications
  • Severe cardiovascular disease – heart failure, poorly controlled hypertension, recent MI
  • Past stroke / brain tumour / intracerebral haemorrhage
• • Adverse Effects
  • Tachycardia
  • Hypertension
  • Diplopia / nystagmus
  • Raised intracranial pressure
  • Nausea / vomiting / anorexia