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Dexmedetomidine

 
Drug Info: Dexmedetomidine

Brand names: Precedex™



Dexmedetomidine injection

What is dexmedetomidine injection?

DEXMEDETOMIDINE (Precedex®) is an anesthetic agent used to reduce anxiety and tension, and promote relaxation and sedation in patients needing a mechanical ventilator. Dexmedetomidine is administered to patients only by health care professionals in an intensive care or surgical area. Generic dexmedetomidine injections are not available.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:
• adrenal insufficiency
• blood vessel disease
• heart disease
• kidney disease
• liver disease
• previous heart attack or stroke
• an unusual or allergic reaction to dexmedetomidine, other anesthetics, other medicines, foods, dyes, or preservatives
• pregnant or trying to get pregnant
• breast-feeding

How should I use this medicine?

Dexmedetomidine is for injection into a vein. It is given by trained health care professionals in an intensive care or surgical area.

Contact your pediatrician or health care professional regarding the use of this medicine in children. Special care may be needed.

Elderly patients over 65 years old may have a stronger reaction to this medicine and need smaller doses.

What if I miss a dose?

This does not apply.

What drug(s) may interact with dexmedetomidine?

• alcohol
• barbiturate medicines for inducing sleep or treating seizures (convulsions)
• medicines for anxiety or sleeping problems, such as diazepam or temazepam
• muscle relaxants
• some medicines for hay fever and other allergies (antihistamines)
• some medicines for depression or mental illness (antidepressants, phenothiazines)
• some medicines for pain (narcotic analgesics, tramadol)

Tell your prescriber or health care professional about all other medicines you are taking, including non-prescription medicines, nutritional supplements, or herbal products. Also tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines.

What should I watch for while taking dexmedetomidine?

You will be closely monitored in an intensive care or surgical area during the administration of dexmedetomidine.

What side effects may I notice from receiving dexmedetomidine?

Side effects that you should report to your prescriber or health care professional as soon as possible:
• confusion
• decreased amount of urine passed
• difficulty breathing, shortness of breath, or wheezing
• dizziness, lightheadedness or fainting spells
• slow heartbeat
• fast or irregular heartbeat
• fever, chills
• palpitations
• numbness or tingling in the hands or feet

Side effects that usually do not require medical attention (report to your prescriber or health care professional if they continue or are bothersome):
• anxiety, nervousness
• blurred vision or other change in vision
• diarrhea
• dizziness
• drowsiness
• dry mouth or thirst
• headaches
• increased sweating
• nausea or vomiting
• pain or irritation at the injection site
• stomach pain or cramps

Where can I keep my medicine?

This medicine is administered only by a health care professional and you will not use this medicine at home.


Last updated: 7/1/2002

Important Disclaimer: The drug information provided here is for educational purposes only. It is intended to supplement, not substitute for, the diagnosis, treatment and advice of a medical professional. This drug information does not cover all possible uses, precautions, side effects and interactions. It should not be construed to indicate that this or any drug is safe for you. Consult your medical professional for guidance before using any prescription or over the counter drugs.

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Wikipedia: Dexmedetomidine
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Dexmedetomidine
Systematic (IUPAC) name
(S)-4-[1-(2,3-dimethylphenyl)ethyl]-3H-imidazole
Identifiers
CAS number 113775-47-6
ATC code N05CM18
PubChem 68602
DrugBank APRD00578
Chemical data
Formula C13H16N2 
Mol. mass 200.28 g/mol
Pharmacokinetic data
Bioavailability  ?
Protein binding 94%
Metabolism near complete hepatic metabolism to inactive metabolites
Half life 2 hours
Excretion urinary
Therapeutic considerations
Pregnancy cat.

?

Legal status
Routes by intravenous infusion only

Dexmedetomidine is a sedative medication used by intensive care units and anesthesiologists, and is marketed under the brand name Precedex (Hospira, Inc.) in the United States. It is relatively unique in its ability to provide sedation without causing respiratory depression. Like clonidine, its mechanism of action is agonism of alpha-2 receptors in certain parts of the brain.[1] It is the S-enantiomer of medetomidine.[2]

Dexmedetomidine has sedative, analgesic, sympatholytic, and anxiolytic effects that blunt many of the cardiovascular responses in the perioperative period. It reduces the volatile anesthetic, sedative and analgesic requirements of the patient without causing significant respiratory depression.[3]

Recent research has suggested dexmedetomidine to be an effective treatment for the dangerous cardiovascular symptoms of cocaine intoxication and overdose.[4] It also seemed to be superior to lorazepam for ventilated patients in the intensive care unit.[5] Compared to midazolam, dexmedetomidine was similarly effective for sedation, but shortened the time to extubation, was associated with less delirium, and experience more bradycardia and less tachycardia and hypertension.[6]

References

  1. ^ Cormack JR, Orme RM, Costello TG. The role of alpha2-agonists in neurosurgery. Journal of Clinical Neuroscience. 2005 May;12(4):375-8.
  2. ^ "Dexmedetomidine - Substance Summary". National Library of Medicine. http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?sid=7847580. Retrieved on 2009-01-26. 
  3. ^ Paris A, Tonner PH. Dexmedetomidine in anaesthesia. Current Opinion in Anaesthesiology. 2005 Aug;18(4):412-8.
  4. ^ Menon DV, Wang Z, Fadel PJ, Arbique D, Leonard D, Li JL, Victor RG, Vongpatanasin W. "Central sympatholysis as a novel countermeasure for cocaine-induced sympathetic activation and vasoconstriction in humans". J Am Coll Cardiol 2007; 50(7): 626-33. PMID 17692748
  5. ^ Pandharipande PP, Pun BT, Herr DL, et al.. "Effect of sedation with dexmedetomidine vs lorazepam on acute brain dysfunction in mechanically ventilated patients: the MENDS randomized controlled trial." JAMA 2007; 298(22): 2644-53. PMID 18073360
  6. ^ Riker RR, Shehabi Y, Bokesch PM, Ceraso D, Wisemandle W, Koura F, Whitten P, Margolis BD, Byrne DW, Ely EW, Rocha MG; for the SEDCOM (Safety and Efficacy of Dexmedetomidine Compared With Midazolam) Study Group. "Dexmedetomidine vs Midazolam for Sedation of Critically Ill Patients: A Randomized Trial " JAMA; Early release online February 2, 2009.

 
 
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