"Dexmedetomidine" Medicine

Therapeutic Class: Miscellaneous sedatives & hypnotics, Miscellaneous sedatives & hypnotics.

Indication: ICU Sedation, Fiberoptic Intubation, Procedural Sedation.

Dosage & Administrations: Adult ICU sedation Loading dose: 1 mcg/kg IV infusion over 10 min. Maintenance infusion: 0.2-0.7 mcg/kg/hr

Procedural sedation Loading dose: 1 mcg/kg IV infusion over 10 min or 0.5 mcg/kg over 10 min is given for less invasive procedures eg ophth surgery. Maintenance infusion: Initially 0.6 mcg/kg/hr, titrated from 0.2-1 mcg/kg/hr to achieve desired clinical effect. Awake fiberoptic intubation patients loading dose: 1 mcg/kg IV infusion over 10 min. Maintenance infusion: 0.7 mcg/kg/hr until endotracheal tube is secured. Rate of all maintenance infusion should be adjusted to achieve the desired level of sedation.

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

Side Effect: Hypotension, bradycardia, sinus arrest, transient HTN & dry mouth.

Precautions & Warnings: Significant CV dysfunction, advanced heart block &\/or severe ventricular dysfunction, hypovolemia, DM, chronic HTN. Renal & hepatic impairment. Do not inj by bolus or rapid IV. Do not administer for >24 hr.

Pregnancy & lactation. Elderly. Childn < 18 yr.

Pregnancy Category:  Pregnancy Category-C

Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.

Mode of Action: Centrally acting alpha2-adrenoceptor agonist that has sedative and anesthetic properties possibly by activating G-proteins in the brainstem, which results in the inhibition of norepinephrine release.

Interaction: Enhanced pharmacologic effects of anaesth, sedatives, hypnotics, opiate agonists, other vasodilators or drugs that have negative chronotropic effects (e.g. cardiac glycosides).