Surgery Book

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Dexmedetomidine

Aka: Dexmedetomidine, Precedex, Dexdor, Dexdomitor
  1. Indications
    1. Post-Intubation Sedation and Analgesia
      1. Short-term sedative in patients on Mechanical Ventilation
    2. Alcohol Withdrawal
  2. Mechanism
    1. Central alpha-2-adrenergic agonist (similar to Clonidine) with sedative properties
  3. Advantages
    1. Offers Sedation while allowing patients to maintain their airway, maintain respirations and respond
    2. Generic
  4. Pharmacokinetics
    1. Onset: 10 minutes
    2. Duration: 1-2 hours
    3. Renal and hepatic metabolism
  5. Dosing
    1. Load: 0.5 to 1 mcg/kg over 10 minutes, then
    2. Infusion: 0.2 to 1.0 mcg/kg/hour (titrated to desired level of Sedation)
    3. Reduce dose in over age 65 years or renal/hepatic Impairment
  6. Adverse Effects
    1. Severe Bradycardia
    2. Hypotension
    3. Dry Mouth
  7. References
    1. Kay (2015) Crit Dec Emerg Med 29(8): 11-17

Dexmedetomidine (C0113293)

Definition (MSH) A imidazole derivative that is an agonist of ADRENERGIC ALPHA-2 RECEPTORS. It is closely-related to MEDETOMIDINE, which is the racemic form of this compound.
Definition (NCI) An imidazole derivate and active d-isomer of medetomidine with analgesic, anxiolytic and sedative properties. Dexmedetomidine selectively binds to presynaptic alpha-2 adrenoceptors located in the brain, thereby inhibiting the release of norepinephrine from synaptic vesicles. This leads to an inhibition of postsynaptic activation of adrenoceptors, which inhibit sympathetic activity, thereby leading to sedation and anxiolysis. The analgesic effect of this agent is mediated by binding to alpha-2 adrenoceptors in the spinal cord.
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D020927
SnomedCT 438079000, 437750002
English (+)-4-((S)-alpha,2,3-Trimethylbenzyl)imidazole, 1H-Imidazole, 4-(1-(2,3-dimethylphenyl)ethyl)-, (R)-, Dexmedetomidine (substance), Dexmedetomidine (product), Dexmedetomidine, Dexmedetomidine [Chemical/Ingredient], DEXMEDETOMIDINE, dexmedetomidine
Swedish Dexmedetomidin
Czech dexmedetomidin
Finnish Deksmedetomidiini
Russian DEKSMEDETOMIDIN, ДЕКСМЕДЕТОМИДИН
Japanese プレセデックス, デキサメデトミジン, デキスメデトミジン, デクスメデトミジン塩酸塩, デクスメデトミジン, 塩酸デクスメデトミジン, D-メデトミジン
Spanish dexmedetomidina, Dexmedetomidina, Dexmedetomidina (sustancia), dexmedetomidina (producto)
Polish Deksmedetomidyna
French Dexmédétomidine
German Dexmedetomidin
Italian Dexmedetomidina
Portuguese Dexmedetomidina
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Precedex (C0876757)

Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D020927
English Hospira Brand of Dexmedetomidine Hydrochloride, Precedex, precedex
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Dexdomitor (C2732176)

Concepts Organic Chemical (T109) , Pharmacologic Substance (T121)
English Dexdomitor
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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