Dexmedetomidine

Dexmedetomidine is a relatively selective alpha2-adrenergic agonist indicated for:

Sedation of initially intubated and mechanically ventilated patients during treatment in an intensive care setting. Administer Dexmedetomidine by continuous infusion 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 the presynaptic alpha-2 adrenoceptors, it inhibits the release if norepinephrine, therefore, terminate the propagation of pain signals. Activation of the postsynaptic alpha-2 adrenoceptors inhibits the sympathetic activity decreases blood pressure and heart rate.

Individualize and titrate Dexmeditomidine dosing to desired clinical effect. Administer Dexmeditomidine using a controlled infusion device. Dilute the 200 mcg/2 mL (100 mcg/mL) vial contents in 0.9% sodium chloride solution to achieve required concentration (4 mcg/mL) prior to administration. The 200 mcg/50 mL single-use bottles do not require further dilution prior to administration. For Adult Intensive Care Unit Sedation : Generally initiate at one mcg/kg over 10 minutes,  followed by a maintenance infusion of 0.2 to 0.7 mcg/kg/hour. For Adult Procedural Sedation : Generally initiate at one mcg/kg over 10 minutes, followed by a maintenance infusion initiated at 0.6 mcg/kg/hour and titrated to achieve desired clinical effect with doses ranging from 0.2 to 1 mcg/kg/hour. Alternative Doses : Recommended for patients over 65 years of age and awake fiberoptic intubation patients.

Co-administration of Dexmedetomidine with anesthetics, sedatives, hypnotics, and opioids is likely to lead to an enhancement of effects.

Body as a Whole : Fever, hyperpyrexia, hypovolemia, light anesthesia, pain, rigors Cardiovascular Disorders, General : Blood pressure fluctuation, heart disorder, hypertension, hypotension, myocardial infarction Central and Peripheral Nervous System Disorders : Dizziness, headache, neuralgia, neuritis, speech disorder, convulsion Gastrointestinal System Disorders : Abdominal pain, diarrhea, vomiting, nausea Liver and Biliary System Disorders : Increased gamma-glutamyl transpeptidase, hepatic function abnormal, hyperbilirubinemia Metabolic and Nutritional Disorders : Acidosis, respiratory acidosis, hyperkalemia, thirst, hypoglycemia Psychiatric Disorders : Agitation, confusion, delirium, hallucination, illusion Red Blood Cell Disorders : Anemia Renal Disorders : Blood urea nitrogen increased, oliguria Respiratory System Disorders : Hypoventilation, hypoxia, pulmonary congestion Skin Disorders : Increased sweating Vascular Disorders : Hemorrhage Vision Disorders : Photopsia, abnormal vision.

Pregnancy Category C.

Continuous monitoring is needed while patient receiving Dexmedetomidine.

Bradycardia, hypotension and cardiac arrest is observed.

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