Ketamine receptor effects

Most intravenous anesthetic agents increasing inhibatory through direct stimulation or potentiation GABA-mediated inhibatory tone.  Ketanmine does NOT interact directly with the GABA recepror.  Ketamine dose interacts with multiple other targets, including NMDA and non-NMDA glutamate receptors, nicotinic and muscarinic cholinergic, monoaminergic, and opioid receptors. In addition, interactions with voltage-dependent ion channels such as Na and L-type Ca channels have been described.  While all of these interactions may be important, it is thought that its action as a non-competitive antagoist at the NMDA receptor account for Ketamine’s analgesic, amnestic, and psychotomimetic effects.