Dexmedetomidine: Difference between revisions
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==General== | ==General== | ||
*Type: [[Alpha-2 | *Type: [[Alpha-2 agonists]]; [[Sedative agents]] | ||
*Dosage Forms:IV | *Dosage Forms:IV | ||
*Common Trade Names: Precedex (US), Dexdor (European) | *Common Trade Names: Precedex (US), Dexdor (European) | ||
==Adult Dosing== | ==Adult Dosing== | ||
===[[ICU Sedation]]=== | |||
*1 mcg/kg over 10 minutes | |||
**Followed by 0.2 to 0.7 mcg/kg/hr | |||
===[[Procedural Sedation]]=== | |||
*1 mcg/kg over 10 minutes | |||
**Followed by 0.6 mcg/hr titrated to effect (generally 0.2 to 1 mcg/kg/hr) | |||
==Pediatric Dosing== | ==Pediatric Dosing== | ||
===Post-Intubation Sedation=== | ===[[ICU sedation|Post-Intubation Sedation]]=== | ||
*Do not bolus | *Do not bolus | ||
*Start at 0.2-0.4 mcg/kg/hour and titrate to a max of 1.4 mcg/kg/hour | *Start at 0.2-0.4 mcg/kg/hour and titrate to a max of 1.4 mcg/kg/hour | ||
| Line 50: | Line 55: | ||
*Hemodynamically neutral medication | *Hemodynamically neutral medication | ||
*Provides sedation with maintenance of arousability, airway protection | *Provides sedation with maintenance of arousability, airway protection | ||
*Preserves sleep architecture and decreases incidence of ICU delirium <ref>Skrobik, Y., Duprey, M., Hill, N. and Devlin, J., 2018. Low-Dose Nocturnal Dexmedetomidine Prevents ICU Delirium. A Randomized, Placebo-controlled Trial. American Journal of Respiratory and Critical Care Medicine, 197(9), pp.1147-1156.</ref> | |||
==See Also== | ==See Also== | ||
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[[Category:Pharmacology]] | [[Category:Pharmacology]] | ||
[[Category:Critical Care]] | |||
Latest revision as of 17:01, 29 November 2020
General
- Type: Alpha-2 agonists; Sedative agents
- Dosage Forms:IV
- Common Trade Names: Precedex (US), Dexdor (European)
Adult Dosing
ICU Sedation
- 1 mcg/kg over 10 minutes
- Followed by 0.2 to 0.7 mcg/kg/hr
Procedural Sedation
- 1 mcg/kg over 10 minutes
- Followed by 0.6 mcg/hr titrated to effect (generally 0.2 to 1 mcg/kg/hr)
Pediatric Dosing
Post-Intubation Sedation
- Do not bolus
- Start at 0.2-0.4 mcg/kg/hour and titrate to a max of 1.4 mcg/kg/hour
- Recommended to start at 0.4 mcg/kg/hour for agitated patients
- Make changes every 15-20 minutes if not desired affect or sooner if patient is agitated
- May use with spot does of other medications like fentanyl and versed.
- If on fentanyl or versed drip already should be able to titrate the dose down.
Special Populations
- Pregnancy Rating: C
- Lactation: Unknown if excreted in milk. Exercise caution
- Renal Dosing
- Adult
- Pediatric
- Hepatic Dosing
- Adult
- Pediatric
Contraindications
- Allergy to class/drug
Adverse Reactions
Serious
- Hypotension
- Bradycardia
- Apnea
Common
- Hypotension
- Bradycardia
- Dry mouth
Pharmacology
- Half-life: 2 hours
- Metabolism: Hepatic
- Excretion: Renal
- Mechanism of Action: Selective α-2 agonist
Comments
- Provides analgesia and anesthesia
- Hemodynamically neutral medication
- Provides sedation with maintenance of arousability, airway protection
- Preserves sleep architecture and decreases incidence of ICU delirium [1]
See Also
References
- ↑ Skrobik, Y., Duprey, M., Hill, N. and Devlin, J., 2018. Low-Dose Nocturnal Dexmedetomidine Prevents ICU Delirium. A Randomized, Placebo-controlled Trial. American Journal of Respiratory and Critical Care Medicine, 197(9), pp.1147-1156.