| DEXMEDETOMIDINE HYDROCHLORIDE
Classifications: alpha2-adrenergic agonist; sedative-hypnotic; Therapeutic: sedative-hypnotic
Prototype: Methoxamine HCl
Pregnancy Category: C
100 mcg/mL injection
Dexmedetomidine stimulates alpha2-adrenergic receptors in the CNS (primarily in the medulla oblongata) causing inhibition of the sympathetic vasomotor center
of the brain. Hemodynamic responses of the heart affected by alpha2 receptors are better controlled with dexmedetomidine than with other related drugs (e.g., midazolam).
Sedative properties utilized in intubating patients and for initially maintaining them on a mechanical ventilator.
Sedation of initially intubated or mechanically ventilated patients.
Hypersensitivity to dexmedetomidine; labor and delivery, including cesarean section, pregnancy (category C).
Patients with arrhythmias or cardiovascular disease, uncontrolled hypertension; hypotension; cerebrovascular disease; renal
or hepatic insufficiency; signs of light anesthesia; lactation; older adults >65 y. Safety and efficacy in children <18 y
Route & Dosage
Adult: IV 1 mcg/kg loading dose infused over 10 min, then continue with infusion of 0.20.7 mcg/kg/h for up to 24 h adjusted
to maintain sedation
Reduce initial dosage.
Clcr <30 mL/min: reduce initial dose
PREPARE: Continuous: Withdraw 2 mL of dexmedetomidine and add to 48 mL of 0.9% NaCl injection. Shake gently to mix.
ADMINISTER: Continuous: Administer using a controlled infusion device. A loading dose of 1 mcg/kg is infused over 10 min followed by the ordered
maintenance dose. Do NOT use administration set containing natural rubber. Do NOT infuse longer than 24 h.
INCOMPATIBILITIES Y-site: Amphotericin B, diazepam.
- Store at 15°30° C (59°86° F).
Adverse Effects (≥1%)Body as a Whole:
Pain, infection. CV: Hypotension,
bradycardia, atrial fibrillation. GI: Nausea,
Hypoxia, pleural effusion, pulmonary edema. Hematologic:
Anemia, leukocytosis. Urogenital:
, general anesthetics
, opiate agonists
, ethanol, tricyclic antidepressants
, tramadol, phenothiazines
, skeletal muscle relaxants
, azatadine, brompheniramine, carbinoxamine, chlorpheniramine, clemastine, cyproheptadine, dexchlorpheniramine, dimenhydrinate, diphenhydramine, doxylamine, hydroxyzine, methdilazine, phenindamine, promethazine, tripelennamine
enhance CNS depression
possibly prolong recovery from anesthesia.
Extensively in liver (CYP2A6). Elimination:
Primarily in urine. Half-Life:
Assessment & Drug Effects
- Monitor for hypertension during loading dose; reduction of loading dose may be required.
- Monitor cardiovascular status continuously; notify physician immediately if hypotension or bradycardia occur.