Dexmedetomidine


Concise Prescribing Info
Indications/Uses
Sedation in critical care.
Dosage/Direction for Use
Adult : IV 0.7 mcg/kg/hr adjusted according to response, w/in the dose range 0.2-1.4 mcg/kg/hr.
Dosage Details
Intravenous
Sedation in critical care
Adult: 0.7 mcg/kg/hr adjusted according to response, w/in the dose range 0.2-1.4 mcg/kg/hr.
Reconstitution
Dilute to a concentration of 4 mcg/mL in glucose 5%, Ringer's, mannitol or NaCl 0.9% soln for inj.
Incompatibility
Incompatible w/ amphotericin B and diazepam.
Contraindications
2nd or 3rd degree AV block (unless paced), uncontrolled hypotension, acute cerebrovascular disorders.
Special Precautions
Patient w/ severe neurological disorders, pre-existing bradycardia, ischaemic heart disease, spinal cord injury, malignant hyperthermia. Avoid abrupt withdrawal after prolonged use. Hepatic and renal impairment. Pregnancy and lactation.
Adverse Reactions
Nausea, vomiting, dry mouth, BP changes, bradycardia, tachycardia, AF, MI, myocardial ischaemia, fever, hypoxia, hyperthermia, anaemia, agitation, pain, pleural effusion, changes in blood sugar.
IV/Parenteral: C
MonitoringParameters
Monitor cardiac and resp function, level of sedation, pain control.
Overdosage
Symptoms: Bradycardia, hypotension, oversedation, somnolence, cardiac arrest. Management: Treat sinus arrest w/ atropine and glycopyrrolate. Resuscitation was needed in isolated cases of severe overdose resulting in cardiac arrest.
Drug Interactions
Enhanced pharmacologic effects of anaesth, sedatives, hypnotics, opiate agonists, other vasodilators or drugs that have negative chronotropic effects (e.g. cardiac glycosides).
Action
Description: Dexmedetomidine is a selective α2-adrenoceptor agonist w/ anaesth and sedative properties. Its action is thought to be due to activation of G-proteins by α2a-adrenoceptors in the brainstem resulting in inhibition of norepinephrine release.
Onset: 5-10 min.
Duration: 60-120 min.
Pharmacokinetics:
Absorption: Time to peak plasma concentration: 15-30 min.
Distribution: Plasma protein binding: Approx 94%.
Metabolism: Almost completely metabolised via direct N-glucuronidation, N-methylation or aliphatic hydroxylation by CYP2A6 isoenzyme.
Excretion: Via urine (95%) and faeces (4%) mainly as metabolites. Terminal elimination half-life: Approx 2 hr.
Storage
Store at 25°C.
References
Anon. Dexmedetomidine. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 11/08/2014.

Buckingham R (ed). Dexmedetomidine Hydrochloride. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 11/08/2014.

Joint Formulary Committee. Dexmedetomidine. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 11/08/2014.

McEvoy GK, Snow EK, Miller J et al (eds). Dexmedetomidine Hydrochloride. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 11/08/2014.

Precedex Injection Solution (Hospira). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 11/08/2014.

Precedex Injection. U.S. FDA. https://www.fda.gov/. Accessed 11/08/2014.

Disclaimer: This information is independently developed by MIMS based on Dexmedetomidine from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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