What is the treatment for adult hypersalivation due to Ketamine?

What is the treatment for adult hypersalivation due to Ketamine?

• A. Glycopyrrolate 2 mg IV
• B. Benadryl 50 mg IM
• C. Atropine: 1 mg IV/IM/IO
• D. Scopolamine 0.4 mg IV

Answer: (C)

Hypersalivation from ketamine is driven by stimulation of muscarinic receptors in the salivary glands, so the best approach is a rapid anticholinergic to block those receptors and reduce secretions. Atropine at 1 mg given IV, IM, or IO works quickly to dry oral secretions, and its effects come on fast enough to be useful in airway-related situations. Its widespread availability and use in acute care make it a practical first-line option for this scenario. While other anticholinergics can also reduce saliva, atropine offers a reliable, fast-acting, multi-route option, which is why it is preferred here. Benadryl doesn’t target salivary secretion specifically, and scopolamine, though effective, has heavier central nervous system effects and a longer, more sedating profile, making atropine the more suitable choice in many acute settings.

Hypersalivation from ketamine is driven by stimulation of muscarinic receptors in the salivary glands, so the best approach is a rapid anticholinergic to block those receptors and reduce secretions. Atropine at 1 mg given IV, IM, or IO works quickly to dry oral secretions, and its effects come on fast enough to be useful in airway-related situations. Its widespread availability and use in acute care make it a practical first-line option for this scenario. While other anticholinergics can also reduce saliva, atropine offers a reliable, fast-acting, multi-route option, which is why it is preferred here. Benadryl doesn’t target salivary secretion specifically, and scopolamine, though effective, has heavier central nervous system effects and a longer, more sedating profile, making atropine the more suitable choice in many acute settings.