Overview
Dexmedetomidine is a selective alpha-2 adrenergic agonist with sedative, anxiolytic, and analgesic properties. It is primarily used for sedation in intensive care settings and procedural sedation, offering the advantage of maintaining respiratory drive and arousability.
Mechanism of Action
Selective agonist of alpha-2 adrenergic receptors in the central nervous system, leading to inhibition of norepinephrine release and subsequent sedation, anxiolysis, and analgesia without significant respiratory depression.
Indications
- Sedation of initially intubated and mechanically ventilated patients during treatment in an intensive care setting
- Sedation of non-intubated patients prior to and/or during surgical and other procedures
Dosage
For ICU sedation: Loading dose of 1 mcg/kg over 10 minutes, followed by maintenance infusion of 0.2-0.7 mcg/kg/hour. For procedural sedation: Loading dose of 1 mcg/kg over 10 minutes, followed by maintenance infusion of 0.2-1 mcg/kg/hour. Adjust based on clinical response.
Contraindications
- Hypersensitivity to dexmedetomidine or any component of the formulation
- Patients with advanced heart block unless pacemaker is in place
Side Effects
- Hypotension
- Bradycardia
- Dry mouth
- Nausea
- Atrial fibrillation
- Hypoxia
- Agitation
- Pyrexia
- Hyperglycemia
Interactions
- Anesthetics, sedatives, hypnotics, opioids: Enhanced sedative effects
- Beta-blockers, calcium channel blockers: Increased risk of bradycardia
- Vasodilators, diuretics: Enhanced hypotensive effects