Dexmedetomidine

Dexmedetomidine is a specific and selective alpha-2 adrenoceptor agonist. By binding to presynaptic alpha-2 adrenoceptors, it inhibits the release of norepinephrine, thereby terminating the propagation of pain signals. Activation of postsynaptic alpha-2 adrenoceptors inhibits sympathetic activity, decreasing blood pressure and heart rate.

• Sedation of intubated and mechanically ventilated patients in ICU (not to exceed 24 hours)
• Sedation of non-intubated patients prior to and/or during surgical and other procedures

Dexmedetomidine is a specific and selective alpha-2 adrenoceptor agonist. By binding to presynaptic alpha-2 adrenoceptors, it inhibits the release of norepinephrine, thereby terminating the propagation of pain signals. Activation of postsynaptic alpha-2 adrenoceptors inhibits sympathetic activity, decreasing blood pressure and heart rate.

Dexmedetomidine activates alpha-2 adrenoceptors, inhibiting norepinephrine release, which reduces sympathetic tone and produces sedation and analgesia.

Adult - ICU Sedation: Load: 1 mcg/kg IV over 10 minutes; Maintenance: 0.2-0.7 mcg/kg/hr IV.
Adult - Procedural Sedation: Load: 1 mcg/kg IV over 10 minutes; Maintenance: 0.6 mcg/kg/hr IV (titrate 0.2-1 mcg/kg/hr).
Elderly (65+)/Fiberoptic Intubation: Load: 1 mcg/kg IV over 10 minutes; Maintenance: 0.7 mcg/kg/hr IV.

This medicine is given as an IV infusion by a healthcare professional. Kindly do not self administer. Use a controlled infusion device. Dilute the 200 mcg/2 mL vial contents in 0.9% sodium chloride to achieve 4 mcg/mL concentration.

Dexmedetomidine is an infusion medicine given by healthcare professionals. You cannot miss a dose yourself.

Common: Decreased blood pressure, dry mouth, bradycardia, hypotension, nausea, atrial fibrillation, agitation, hypertension.
Other: Fever, hyperpyrexia, hypovolemia, myocardial infarction, headache, convulsion, abdominal pain, diarrhea, anemia, hypoglycemia, hallucination, oliguria, hypoventilation, hypoxia.

Continuous monitoring of heart rate, blood pressure, respiratory rate, and oxygen level is required. Caution in 2nd/3rd degree AV block, uncontrolled hypotension, acute cerebrovascular disorders. Dose reduction may be required in hepatic impairment.

2nd or 3rd degree AV block (unless paced); uncontrolled hypotension; acute cerebrovascular disorders.

Anesthetics, sedatives, hypnotics, opiate agonists, vasodilators, negative chronotropic drugs: Enhanced pharmacologic effects.

Dexmedetomidine may cause excessive drowsiness with alcohol.

Pregnancy Category C. Dexmedetomidine may be unsafe during pregnancy. Animal studies have shown harmful effects on the developing baby.

Dexmedetomidine is probably safe during breastfeeding. Limited human data suggests that the drug does not represent any significant risk to the baby.

Safety and effectiveness in pediatric populations have not been established.

Alternative dosing may be required for patients over 65 years of age.

Renal impairment: Safe in kidney disease. No dose adjustment recommended.
Hepatic impairment: Use with caution. Dose adjustment may be required.

Overdose may lead to bradycardia, hypotension, and cardiac arrest.

Keep below 30°C temperature, away from light & moisture. Keep out of reach of children.

Dexmedetomidine