Molecular Mechanisms and Toxic Effects of Ketamine.
Yu-Meng Zuo, Wei Han, Jian-Bo Zhang, Tao Li
Fa yi xue za zhi April 25, 2025 DOI: 10.12116/j.issn.1004-5619.2024.341002 via PubMed
Summary
Ketamine, a dissociative anesthetic used clinically for surgical anesthesia, can cause nerve damage, adverse emotional reactions, and other toxic side effects when abused. Its primary mechanism blocks N-methyl-D-aspartate receptors (NMDAR), but it also acts through multiple other pathways including AMPAR, opioid receptors, GABA receptors, monoaminergic receptors, cholinergic receptors, HCN channels, voltage-gated sodium channels, and L-type voltage-dependent calcium channels. This review summarizes the molecular mechanisms and toxic effects of ketamine to support forensic applications such as identifying symptomatic phenotypes of ketamine toxicity and detecting ketamine abuse.
Study at a glance
| Characteristics | Review Peer reviewed |
|---|---|
| Topics | Ketamine |
| Keywords | Forensic pathology Forensic toxicology Molecular mechanism Toxic effect |
| Key finding | Ketamine exerts its pharmacological effects primarily by blocking NMDAR and also through numerous other receptor and channel pathways, with abuse leading to nerve damage and adverse emotional reactions. |
Abstract
Ketamine is a dissociative anesthetic. It is clinically used as a surgical anesthetic or anesthetic inducer and has a certain degree of mental dependence. Its abuse can lead to nerve damage, adverse emotional reactions and other toxic side effects. The primary mechanism by which ketamine exerts its pharmacological effects is to block N-methyl-D-aspartate receptors (NMDAR). It also functions through pathways such as α-amino-3-hydroxy-5-methyl-4-isox-azolepropionic acid receptors (AMPAR), opioid receptors, γ-aminobutyric acid (GABA) receptors, monoaminergic receptors, cholinergic receptors, hyperpolarization-activated cyclic nucleotide-gated (HCN) channels, voltage-gated sodium channels, and L-type voltage-dependent calcium channels (VDCC). This article summarizes the molecular mechanism and toxic effects of ketamine's pharmacological functions, in order to provide a basis for forensic applications such as the identification of symptomatic phenotypes of ketamine toxic effects and the identification of ketamine abuse.